Treatment decision-making in breast cancer: the patient–doctor relationship - Semantic Scholar
Engaging individuals with cancer in their treatment decision making has . than those with hematologic cancers29, 30; breast cancer patients, The most common physician‐perceived barriers to SDM include: 1) time . that visually depicts the relationships among key factors, processes, and outcomes It is often said that relationships between patients and doctors have changed . she preferred not to have the responsibility of making a decision about surgery. Verite's doctors were directive in telling her which breast cancer treatment to. However, shared decision making and doctor–patient relationship have been linked . Breast Cancer Research and Treatment, , –
Treatment decision-making in breast cancer: the patient-doctor relationship.
There were few studies conducted in Australia and United States reporting significant barriers to participation in treatment decision-making among breast cancer patients from minority cultures. Patients with recurrent breast cancer, cognitive impairment, severe illness at the time of study, or language barriers were ineligible for participation.
Screened patients were recruited after their consultation with their physician, who initially introduced them to the study. They were given a brief explanation about the study and signed the informed consent form if they agreed to participate.
Each patient and physician was required to complete a set of questionnaires after the consultation, which was the consultation in which patients made the decision for their treatment. Both the questionnaires were translated into Malay and back translated to English by independent bilingual individuals.
- Treatment decision-making in breast cancer: the patient–doctor relationship
- Treatment decision-making in breast cancer: the patient-doctor relationship.
- Shared decision making
Content validation was performed by the consultants oncologists and breast surgeon involved in this study. The translated version was tested in a pilot study with 30 patients who had no trouble in understanding and completing all the questionnaires.
No revisions were made to the study measures based on the results of the pilot study. CPS The CPS was created to assess the preferred level of involvement of patients in their treatment decision-making process. However, the scoring was reversed for negatively worded items. Descriptive statistics were used to describe the sample. Univariate analysis was applied to test for an individual predictor with a dependent variable.
However, only The most common reasons for not participating reported by the patients were that they were busy, felt uncomfortable participating, were emotionally unstable, or were being interviewed in another study. Sixty-eight physicians participated in this study. Therefore, there were a total of consultations with physician—patient dyads.
Sociodemographic characteristics of the patients are shown in Table 1. More than half of the participants were Malay Sociodemographic characteristics of the physicians are shown in Table 2.
Treatment decision-making among breast cancer patients in Malaysia
Majority of the physicians were medical officers Table 1 Sociodemographic characteristics of patients Abbreviation: Table 2 Sociodemographic characteristics of physicians Abbreviations: A total of However, physicians perceived otherwise, stating that they thought most patients were active The overall concordance in treatment decision-making between patients and physicians was Malay patients were 2.
Patients with a diploma, degree, or postgraduate qualification were 7. OR, odds ratio; CI, confidence interval.
I think it's difficult for people nowadays if they're asked which sort of treatment they like because it's quite a responsibility. And often people, although the surgeon explains, I think it's often people feel they'd rather just be told what the surgeon would like to do.
Apparently nowadays that is the choice, well it is in our breast clinics - that they can have a choice of just whether they want the whole breast off, whether they want a lumpectomy, or whether they'd like to leave it to the surgeon to think what he'd like best.
And I'm sure I would leave it to the surgeon for what he thought was best if I had choices like that.
Sometimes there is little uncertainty about the best course of treatment and the doctor feels justified in giving a very clear steer. A woman with breast cancer told us that she had hoped that she would be able to have the lump removed but her surgeon told her that would not be sufficient and they she needed to have a mastectomy.
She trusted his advice. There are also occasions when people prefer to be told what to do: One of the problems with a very directive approach is that if the side effects are very unpleasant or the treatment does not go as planned the patient can be left feeling that they were poorly advised, or at least unprepared for the consequences.
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