Using patient and physician perspectives to develop a shared decision-making framework for colorectal cancer

Abstract

BackgroundColorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient-centred care, there has been little investigation of patient and physician shared decision-making preferences and practices or the outcomes associated with shared decision making in the context of colorectal cancer.AimThe aim of this study is to determine patient and physician attitudes towards the use of shared decision making in the setting of colorectal cancer.MethodsStandard principles of qualitative research will be used to sample and interview 20 colorectal cancer patients in each of three tertiary care hospitals (n = 60) and 15 surgeons, radiation oncologists, and medical oncologists (n = 45) affiliated with cancer centres. The interview questions will be guided by a conceptual framework defining patient and physician factors that influence the shared decision-making process and associated outcomes in the setting of colorectal cancer. An inductive, grounded approach will be used by two investigators to independently analyze the interview transcripts. These investigators will meet to compare and achieve consensus on themes that will be tabulated to compare barriers, enablers, and outcomes of shared decision making by patient, physician, and contextual factors.DiscussionThis study is the first to examine both patient and physician perspectives on the use of shared decision making for colorectal cancer in North America or elsewhere. It will provide a framework that can be used to describe the shared decision-making process and its outcomes, and evaluate strategies to facilitate this process for patients with colorectal cancer.

The mediating effect of trust on the relationship between doctor–patient communication and patients' risk perception during treatment

“…The model in the current study is also appropriate for shared decision‐making. Leon‐Carlyle et al () proposed the framework of shared decision‐making defining patient and physician variables that influence the shared decision‐making process and associated outcomes. Patients' factors includes age, education level, perceived urgency, trust in physician, and emotional support network whereas communication training is included in physician variables.…”

Does geography influence the treatment and outcomes of colorectal cancer? A population-based analysis

“…Both system- and patient-related factors could explain this disparity. Patient-related factors in health decision making may be numerous, including age, gender, education, emotional support, and physician trust [24]. Anxiety, personal beliefs, or aversion to postoperative complications may influence patients to not seek or receive therapy [25,26].…”

Using a bubble chart to enhance adherence to quality-of-care guidelines for colorectal cancer patients

“…Colorectal cancer is the third leading cause of cancer‐related death worldwide, with over 900 000 diagnoses and 639 000 deaths each year (Leon‐Carlyle et al . 2009).…”

“…Colorectal cancer is the third leading cause of cancerrelated death worldwide, with over 900 000 diagnoses and 639 000 deaths each year (Leon-Carlyle et al 2009). Sixty per cent of these patients present with stage II or III disease, which recurs with metastatic or locally invasive disease in approximately 35-40% of patients (Arends 2010;Jonsson et al 2010).…”