Poster Presentation COSA 2015 ASM

The experiences and preferences of shared decision making and their associated factors among cancer patients undergoing radiation therapy     (#263)

Megumi Uchida 1 2 , Chikao Sugie 3 , Michio Yoshimura 4 , Eiji Suzuki 5 , Yuta Shibamoto 3 , Masahiro Hiraoka 6 , Masakazu Toi 7 , Tatsuo Akechi 2 8
  1. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  2. Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Aichi, Japan
  3. Department of radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, JAPAN
  4. Department of radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine , Kyoto, Japan
  5. Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
  6. Department of radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
  7. Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
  8. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan

Aim:

Researches suggestthat shared decision making (SDM) increases patients' involvement in healthcare decisions but the experiences and preferences of SDM and their associated factors in cancer patients are undetermined. This study aimed to investigate 1) the experiences and preferences of SDM and their associated factors, 2) the factors that associated with the participants who preferred and experienced SDM, among cancer patients undergoing radiation therapy.

Methods:

Cancer patients aged 20 years or older were consecutively sampled when they started radiation therapy at two university hospitals. The patients were asked to complete self-administered questionnaires concerning their experiences and preferences of SDM, psychological distress, physical symptoms, quality of life, sociodemographic and medical factors, physician’s communication style(e.g.; ” The doctors at the hospital gave me all of the treatment I could have.”), and provision of psychological, physical and practical support.

Results:

Among the 167 patients (response rate: 66%), 69% experienced and 83% preferred SDM. 83% recognized their aim of radiation therapy as curative. A multiple regression analysis revealed that one item of patient’s factor (higher education) and one item of physician’s communication style (“The staff at the hospital helped me to get financial assistance“) were significantly associated with experience of SDM and that one item of patient’s factor (higher age) and one item of physician’s communication style (“The staff at the hospital showed respect for me”) were significantly associated with preference of SDM.

Conclusions:

Most cancer patients undergoing radiation therapy tend to prefer shared decision making. Communication including respects to patients might increase SDM and physicians need to take patients’ age into account when they decide treatment.