What Is the Impact of Shared Decision Making on Treatment and Outcomes for Older Women With Breast Cancer?

Mandelblatt, Jeanne S.; Kreling, Barbara; Figeuriedo, Melissa; Feng, Shibao

doi:10.1200/jco.2006.07.1159

Cited by 111 publications

(99 citation statements)

References 32 publications

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“…(19) 19 (18) 5 (5) There have been other reports of parents' perceived lack of choice [12] and reliance on the physician's recommendation [13,14]. Studies of shared decision-making have found that certain classes of patients do not wish to participate in the decision: those with more serious and life-threatening illnesses [15,16], those for whom there are no alternative treatments [17], or those for whom evidence is lacking for the next treatment [18]. These shared decision-making discussions frame the issue as a decision that one could refuse to participate in or be excluded from.…”

Section: Discussionmentioning

confidence: 99%

Shared Decision-Making in Pediatric Allogeneic Blood and Marrow Transplantation: What If There Is No Decision to Make?

Pentz¹,

Pelletier

Alderfer

et al. 2012

The Oncologist

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Learning Objectives: After completing this course, the reader will be able to: When the alternative to medical treatment is likely death, ask parents and children whether they agree to the medical plan rather than suggesting they are sharing in “a decision.” Use the model of shared decision in appropriate settings, that is, those in which a bona fide choice exists. This article is available for continuing medical education credit at http://CME.TheOncologist.com Introduction. Shared decision‐making between health care professionals, patients, parents, and guardians is widely recommended today. However, it is unclear what happens when collaborative language is used by physicians in clinical situations for which patients and parents/guardians believe there is no decision to be made. Methods. We conducted a qualitative study of decision‐making for pediatric allogeneic blood and marrow transplantation by interviewing patients, parents, grandparents, donor siblings, and nondonor children after the decision to proceed to transplant but before the transplantation. Each interview was audio recorded, transcribed, and coded for major themes. Results. In total, 107 members of 30 families at four sites were interviewed, including 15 patients, 22 mothers, 2 stepmothers, 1 grandmother, 19 fathers, 3 stepfathers, 1 grandfather, 13 sibling donors, and 31 nondonor children (siblings, half‐siblings, and cousins). In all, 81% of parents/guardians, 73% of patients, 31% of donors, and 29% of other children reported there was no decision to be made. Almost all (88%) parents/guardians indicated that the physician's recommendation was a large determinant in their agreement to go forward with the transplantation. All parents/guardians reported that “agreeing to a plan” was a better description of what their consent entailed. Conclusions. To be respectful of patients and parents/guardians, we suggest that “agreeing to a plan” may be a better description for what parents/guardians must consider when the alternative to a transplantation is likely death. In this clinical context, the shared decision‐making model with a focus on “a decision to be made” may be misleading.

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Section: Discussionmentioning

confidence: 99%

Shared Decision-Making in Pediatric Allogeneic Blood and Marrow Transplantation: What If There Is No Decision to Make?

Pentz¹,

Pelletier

Alderfer

et al. 2012

The Oncologist

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“…116 Understanding impairment risk and symptoms associated with early impairment identification activates patients toward better self-management and self-advocacy for care, 117 improves patient satisfaction and quality of life, and reduces anxiety. [118][119][120][121] A multipronged approach that targets provider, process, and patients is needed to improve the integration of cancer rehabilitation services into the cancer continuum. Efforts are underway to improve cancer rehabilitation education and to elevate the knowledge and skills requisite of a specialty workforce.…”

Section: Interdisciplinary Clinical Integration Of Rehabilitationmentioning

confidence: 99%

Toward a National Initiative in Cancer Rehabilitation: Recommendations From a Subject Matter Expert Group

Stout

Silver

Raj

et al. 2016

Archives of Physical Medicine and Rehabilitation

150

120

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The health care delivery system in the United States is challenged to meet the needs of a growing population of cancer survivors. A pressing need is to optimize overall function and reduce disability in these individuals. Functional impairments and disability affect most patients during and after disease treatment. Rehabilitation health care providers can diagnose and treat patients' physical, psychological, and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence and improve quality of life in this medically complex population. However, few care delivery models integrate comprehensive cancer rehabilitation services into the oncology care continuum. The Rehabilitation Medicine Department of the Clinical Center at the National Institutes of Health with support from the National Cancer Institute and the National Center for Medical Rehabilitation Research convened a subject matter expert group to review current literature and practice patterns, identify opportunities and gaps regarding cancer rehabilitation and its support of oncology care, and make recommendations for future efforts that promote quality cancer rehabilitation care. The recommendations suggest stronger efforts toward integrating cancer rehabilitation care models into oncology care from the point of diagnosis, incorporating evidence-based rehabilitation clinical assessment tools, and including rehabilitation professionals in shared decision-making in order to provide comprehensive cancer care and maximize the functional capabilities of cancer

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“…Studies of cancer survivors suggest that some older patients want family to make decisions for them 68,69 ; inclusion of significant others in discussions of cancer management is also associated with older patients reporting higher levels of shared decision-making. 70 These data suggest that involving significant others in discussions regarding cancer screening may improve older adults' decision-making as well, and better protect their interests, particularly if that communication is tailored to their needs and concerns. 71 To our knowledge, few studies to date have been conducted among individuals aged 65 years, however.…”

Section: Social Supportmentioning

confidence: 99%

Cancer screening and aging: Research barriers and opportunities

Gorin

Gauthier

Hay

et al. 2008

Cancer

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Cancer is the second most common cause of death among those aged 65 years, and is a major cause of morbidity. There is some evidence that screening, by detecting precancerous lesions in asymptomatic patients, is effective in reducing cancer-related morbidity and mortality among older men and women. The objectives of the current review article were to identify some of the barriers to and opportunities for research in cancer screening among older individuals. Using expert opinion, the authors developed a taxonomy of barriers to research among those aged 65 years at 3 levels: the macro (policy and population), the organi-

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What Is the Impact of Shared Decision Making on Treatment and Outcomes for Older Women With Breast Cancer?

Abstract: SDM plays an important role in the process of care for older women with breast cancer. Physicians treating this growing population have a simple, but powerful tool for improving outcomes within their grasp-spending time to engage and involve older women in their breast cancer care.

Cited by 111 publications

References 32 publications

Shared Decision-Making in Pediatric Allogeneic Blood and Marrow Transplantation: What If There Is No Decision to Make?

Shared Decision-Making in Pediatric Allogeneic Blood and Marrow Transplantation: What If There Is No Decision to Make?

Toward a National Initiative in Cancer Rehabilitation: Recommendations From a Subject Matter Expert Group

Cancer screening and aging: Research barriers and opportunities

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