Priorities for the Head and Neck Cancer Patient, their Companion and Members of the Multidisciplinary Team and Decision Regret (original) (raw)

Shared decision making in head neck cancer

oral oncology reports, 2023

Shared decision making (SDM) has been presented as an ethical framework for cancer care decision making. It is, however, difficult to apply and lacks practicality. SDM is a partnership between physicians and patients that combines personal values and preferences with the most up-to-date medical knowledge. It has the ability to reduce choice conflicts, foster value congruence, and boost patient participation. However, little study has been conducted on the attitudes of patients and surgeons towards SDM in surgical decision-making. Patients and surgeons favoured the SDM in general, but none of the trials looked at decision preferences in an emergency situation. There is a need to broaden research into new and demanding therapeutic contexts.

Decision making in the cancer context: An introduction to the special series

Annals of Behavioral Medicine, 2006

, the Cancer Special Interest Group of the Society of Behavioral Medicine (SBM) held a Pre-Conference Scientific Meeting on "Decision-Making in the Cancer Context-Translation from Basic Science through Population Health." The overall goals of the meeting were to come to a better understanding of behavioral science approaches to investigating decision making and to evaluate innovative models of patient decision support delivery, as well as to consider the population health applications of this work. The Pre-Conference Scientific Meeting considered (a) basic and behavioral issues in the affective and social dimensions of patient decision making and decision support; (b) approaches to shared decision making and patient decision support; (c) the role of values perspectives and bioethics related to shared decision making, for individuals and health care providers; and (d) models of delivery to support

Shared decision-making and the lessons learned about decision regret in cancer patients

Supportive Care in Cancer

The commentary presents reflections on the literature on post-treatment cancer patient regret. Even though a lot of effort has been made to increase patient satisfaction by engaging them in medical decisions, patient regret remains present in clinical settings. In our commentary, we identify three main aspects of shared decision-making that previously have been shown to predict patient regret. Based on these findings, we provide recommendations for physicians involved in the shared decision-making process. In addition, we make methodological suggestions for future research in the field.

Sharing decisions in cancer care

Social Science & Medicine, 2001

Previous studies have demonstrated that the majority of cancer patients fail to achieve their desired level of participation during treatment decision making. However, it is unclear whether this failure affects patient well-being and satisfaction. Furthermore, whilst shared decision making is currently espoused as the preferred model for doctorpatient relations, little empirical evidence exists showing it has beneficial effects for patients. We aimed to evaluate the impact of shared decision making and the achievement of preferred role on patient anxiety, recall of information, and satisfaction. Patients with cancer indicated their preferred level of participation in decision making and preferences for information and emotional support prior to their initial consultation with an oncologist. Anxiety was assessed prior to and immediately after the consultation and recall seven days after the consultation. Anxiety was reassessed at twoweeks post-consultation at which time patients also reported their satisfaction with the consultation and perceived role of participation in treatment decision making. Satisfaction with the information and emotional support received was also evaluated.

Patient Preferences for Shared Decision Making: Not All Decisions Should Be Shared

Journal of the American Academy of Orthopaedic Surgeons, 2019

Introduction: To assess bounds of shared decision making in orthopaedic surgery, we conducted an exploratory study to examine the extent to which patients want to be involved in decision making in the management of a musculoskeletal condition. Methods: One hundred fifteen patients at an orthopaedic surgery clinic were asked to rate preferred level of involvement in 25 common theoretical clinical decisions (passive [0], semipassive [1 to 4], equally shared involvement between patient and surgeon [5], semiactive [6 to 9], active [10]). Results: Patients preferred semipassive roles in 92% of decisions assessed. Patients wanted to be most involved in scheduling surgical treatments (4.75 ± 2.65) and least involved in determining incision sizes (1.13 ± 1.98). No difference exists in desired decision-making responsibility between patients who had undergone orthopaedic surgery previously and those who had not. Younger and educated patients preferred more decision-making responsibility. Thos...

Why shared decision making is not good enough: lessons from patients

Journal of Medical Ethics, 2013

A closer look at the lived illness experiences of medical professionals themselves shows that shared decision making is in need of a logic of care. This paper underlines that medical decision making inevitably takes place in a messy and uncertain context in which sharing responsibilities may impose a considerable burden on patients. A better understanding of patients' lived experiences enables healthcare professionals to attune to what individual patients deem important in their lives. This will contribute to making medical decisions in a good and caring manner, taking into account the lived experience of being ill. enough: lessons from patients Why shared decision making is not good http://jme.bmj.com/content/40/7/493.full.html Updated information and services can be found at: These include: References http://jme.bmj.com/content/40/7/493.full.html#ref-list-1 This article cites 11 articles, 7 of which can be accessed free at: service Email alerting the box at the top right corner of the online article. Receive free email alerts when new articles cite this article. Sign up in Notes http://group.bmj.com/group/rights-licensing/permissions To request permissions go to: http://journals.bmj.com/cgi/reprintform To order reprints go to: http://group.bmj.com/subscribe/

Capturing Treatment Decision Making Among Patients With Solid Tumors and Their Caregivers

Oncology Nursing Forum, 2013

Purpose/Objectives-To examine the feasibility and acceptability of using a decision aid with an interactive decision-making process in patients with solid tumors and their caregivers during cancer-related treatment. Research Approach-A phenomenologic approach was used to analyze qualitative data, with a focus on the meaning of participants' lived experiences. Interviews were conducted by telephone or in person. Setting-Outpatient clinics at two regional cancer centers. Participants-160 total individuals; 80 patients with newly diagnosed breast (n = 22), advancedstage prostate (n = 19), or advanced-stage lung (n = 39) cancer, and their caregivers (n = 80). Methodologic Approach-Twenty-seven of the 80 pairs engaged in audio recorded interviews that were conducted using a semistructured interview guide. Continuous text immersion revealed themes. Validity of qualitative analysis was achieved by member checking. Findings-Significant findings included three themes: (a) the decision aid helped patients and caregivers understand treatment decisions better, (b) the decision aid helped patients and caregivers to be more involved in treatment decisions, and (c) frequent contact with the study nurse was valuable. Conclusions-Decision making was more complex than participants expected. The decision aid helped patients and caregivers make satisfying treatment decisions and become integral in a shared treatment decision-making process. Interpretation-Decision aids can help patients and their caregivers make difficult treatment decisions affecting quantity and quality of life during cancer treatment. The findings provide valuable information for healthcare providers helping patients and their caregivers make treatment decisions through a shared, informed, decision-making process. Knowledge Translation-Decision aids can be helpful with treatment choices. Caregivers' understanding about treatment is just as important in the decision-making process as the patients' understanding. Incorporating decision aids that are delivered by healthcare providers or trained personnel has the potential to improve patients' decision satisfaction. The development of decision aids for patients with cancer has helped to engage patients in decision making. Engaging in a shared decision-making process may reduce decisional conflict when making a choice regarding cancer treatment and may set the stage for more positive outcomes. Decision aids, which prepare patients to participate and share in their

Clinical issues in shared decision-making applied to breast cancer

Health Expectations, 2003

Objectives To assess (1) the clinical issues addressed during the medical encounter; (2) the feasibility of the process of shared decision-making in clinical practice and (3) patientsÕ desires concerning the question of Ôwho should take the decision in breast cancer treatments?Õ Design Qualitative pilot study based on clinical encounters using decision boards and information booklets. Setting Centre Le´on Be´rard, a comprehensive cancer centre in the Rhoˆne-Alpes region of France. Participants One breast cancer surgeon and 22 breast cancer patients. Main outcome measures Analysis of patientsÕ reactions to a shared decision-making process concerning surgery and chemotherapy, and analysis of its practical feasibility (i.e. duration of the consultations). Results (1) Twenty-one patients participated in the decision regarding surgery; all chose conservative treatment; 15 patients had their own say about chemotherapy (nine chose no chemotherapy, six chose chemotherapy). (2) Participating in treatment choice generated anxiety for a majority of patients. Some were dissatisfied because they had to make a choice and consequently to give up the other option. Finally, some were uncertain about making the right choice. Nevertheless, most were satisfied with the information given and the possibility of participating to the treatment decision-making process. (3) The total duration of the entire process of shared decision-making is consistent with the time spent with patients with such a severe disease. Discussion/conclusion Most of the patients expressed their satisfaction regarding the possibility to participate in treatment decisionmaking, knowing that offering treatment choice is very unusual in France. From this pilot study it appears that shared decision-making is feasible in clinical practice. Nevertheless, a quantitative study based on a large sample of patients is necessary to: (1) confirm this