589 Early stage, low grade endometrial adenocarcinoma in reproductive aged women. an evaluation of patient perspectives of diagnosis, treatment decision making, management, fertility and survivorship: a qualitative study

Background: Independent decision-making is one of the basic rights of patients. However, in clinical practice, most older cancer patients’ treatment decisions are made by family members. Objective: This study attempted to analyze the treatment decision-making process and formation mechanism for older cancer patients within the special cultural context of Chinese medical practice. Method: A qualitative study was conducted. With the sample saturation principle, data collected by in-depth interviews with 17 family members and 12 patients were subjected to thematic analysis. Ethical considerations: The study was approved by the ethics committees of Sun Yat-sen University. All participants provided verbal informed consent after being told their rights of confidentiality, anonymity, and voluntary participation. They had the right to refuse to answer questions and could withdraw at any time. Results: Three themes emerged: (1) complex process; (2) transformation of family decision-making power; and (3) individual compromise. Family members inevitably had different opinions during the long process of treatment decision-making for older cancer patients. The direction of this process could be regarded as an extension of the family power relationship. The patient usually compromised the decision to survive, which was made by family members. Conclusion: This study describes the treatment decision-making process of older cancer patients in the context of Chinese culture. The reasons underlying this process are related to the views on life and death and family values. An individual is a part of the family, which is often seen as the minimal interpersonal unit in Chinese society. It is significant that while emphasizing patient autonomy in the decision-making process, health professionals should also pay attention to the important roles of culture and family.

Download Full-text

Do bowel cancer patients participate in treatment decision-making? Findings from a qualitative study

European Journal of Cancer Care ◽

10.1046/j.1365-2354.2003.00370.x ◽

2003 ◽

Vol 12 (2) ◽

pp. 166-175 ◽

Cited By ~ 18

Author(s):

T. SANDERS ◽

S. SKEVINGTON

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Cancer Patients ◽

Treatment Decision ◽

Bowel Cancer ◽

Treatment Decision Making

Download Full-text

Women's Interest in Gene Expression Analysis for Breast Cancer Recurrence Risk

Journal of Clinical Oncology ◽

10.1200/jco.2006.09.6255 ◽

2007 ◽

Vol 25 (29) ◽

pp. 4628-4634 ◽

Cited By ~ 26

Author(s):

Suzanne C. O'Neill ◽

Noel T. Brewer ◽

Sarah E. Lillie ◽

Edward F. Morrill ◽

E. Claire Dees ◽

...

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Early Stage ◽

Cancer Recurrence ◽

Treatment Decision ◽

Recurrence Risk ◽

Anticipated Regret ◽

Treatment Decision Making ◽

Potential Benefits ◽

Previously Treated

Purpose Genomic and other technologies are improving the accuracy with which clinicians can estimate risk for recurrence (RFR) of breast cancer and make judgments about potential benefits of chemotherapy. Little is known of how patients will respond to genomic RFR testing or interact with their physicians to make informed decisions regarding treatment. We assessed interest in genomic RFR testing and patient preferences for incorporating results into treatment decision making. Patients and Methods One hundred thirty-nine women previously treated for early-stage breast cancer completed surveys that presented hypothetical scenarios reflecting different test outcomes and potential decisions. We assessed women's attitudes toward RFR testing, how results would affect their choices about adjuvant treatment, and potential concerns about and perceived benefits of testing. Results The majority of participants said they would “definitely” want to be tested (76%), receive their results (87%), and discuss these results with their physicians. They were willing to pay, on average, $997 for testing. Those who expressed more concerns about testing were less interested in testing and in incorporating results into treatment decision making. Participants were more likely to want chemotherapy when presented with high-risk results and would worry more about those results. They were least likely to trust and most likely to express potential anticipated regret in response to intermediate RFR results. Conclusion Participants expressed strong interest in testing. Although these decisions were sensitive to RFR, participants’ complex reactions to intermediate RFR suggest care is needed when communicating such results.

Download Full-text

Key elements of optimal treatment decision-making for surgeons and older patients with colorectal or pancreatic cancer: A qualitative study

Patient Education and Counseling ◽

10.1016/j.pec.2016.10.013 ◽

2017 ◽

Vol 100 (3) ◽

pp. 473-479 ◽

Cited By ~ 8

Author(s):

Noralie H. Geessink ◽

Yvonne Schoon ◽

Hanneke C.P. van Herk ◽

Harry van Goor ◽

Marcel G.M. Olde Rikkert

Keyword(s):

Pancreatic Cancer ◽

Decision Making ◽

Qualitative Study ◽

Older Patients ◽

Treatment Decision ◽

Optimal Treatment ◽

Treatment Decision Making

Download Full-text

“It’s important to me”: A qualitative analysis of shared decision-making and patient preferences in early-stage breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.227 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 227-227

Author(s):

Valerie Lawhon ◽

Rebecca England ◽

Audrey S. Wallace ◽

Courtney Williams ◽

Stacey A. Ingram ◽

...

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Shared Decision Making ◽

Patient Preferences ◽

Early Stage ◽

Treatment Decision ◽

Treatment Decisions ◽

Early Stage Breast Cancer ◽

Shared Decision ◽

Treatment Decision Making

227 Background: Shared decision-making (SDM) occurs when both patient and provider are involved in the treatment decision-making process. SDM allows patients to understand the pros and cons of different treatments while also helping them select the one that aligns with their care goals when multiple options are available. This qualitative study sought to understand different factors that influence early-stage breast cancer (EBC) patients’ approach in selecting treatment. Methods: This cross-sectional study included women with stage I-III EBC receiving treatment at the University of Alabama at Birmingham from 2017-2018. To understand SDM preferences, patients completed the Control Preferences Scale and a short demographic questionnaire. To understand patient’s values when choosing treatment, semi-structured interviews were conducted to capture patient preferences for making treatment decisions, including surgery, radiation, or systemic treatments. Interviews were audio-recorded, transcribed, and analyzed using NVivo. Two coders analyzed transcripts using a constant comparative method to identify major themes related to decision-making preferences. Results: Amongst the 33 women, the majority of patients (52%) desired shared responsibility in treatment decisions. 52% of patients were age 75+ and 48% of patients were age 65-74, with an average age of 74 (4.2 SD). 21% of patients were African American and 79% were Caucasian. Interviews revealed 19 recurrent treatment decision-making themes, including effectiveness, disease prognosis, physician and others’ opinions, side effects, logistics, personal responsibilites, ability to accomplish daily activities or larger goals, and spirituality. EBC patient preferences varied widely in regards to treatment decision-making. Conclusions: The variety of themes identified in the analysis indicate that there is a large amount of variability to what preferences are most crucial to patients. Providers should consider individual patient needs and desires rather than using a “one size fits all” approach when making treatment decisions. Findings from this study could aid in future SDM implementations.

Download Full-text