A mixed-methods approach to work towards patient-centered decision making in cancer care

Introduction:

Many cancer patients have to choose between a variety of treatment options. Optimal cancer care should allow patients to participate in these decisions, to the extent they desire. However, many cancer patients are not adequately involved in their treatment decisions. This body of work examined cancer patients' preferences for and experiences with making treatment decisions.

Methods:

A mixed-methods approach was employed. Qualitative data was used to develop strategies to improve patient-centred decision making in cancer care. The generalisability of these strategies was examined with the help of a larger, more heterogeneous sample of cancer patients and their support persons. One qualitative interview study (n = 24) and two cross-sectional survey studies (n = 223 and n = 423) were conducted. Participants were recruited from medical and radiation oncology waiting rooms of treatment centres across New South Wales and Victoria, Australia.

Results:

Patient-centred decision making is not always delivered to cancer patients. Patients may feel overwhelmed when being presented with their treatment options which limits their ability to participate in these decisions. Clinicians should consider asking patients about their preferences for involvement in decision making and offer two shorter consultations combined with written and online information, rather than one longer consultation and written information only, when making cancer treatment decisions.

Discussion:

The findings of this research make an important contribution to increasing our understanding of how treatment decision making could be improved in clinical practice. Future research should use methodologically rigorous intervention studies to assess the impact of different consultation styles on patient outcomes.