Artikel
Cancer patients’ preferred and perceived roles in decision-making in a representative German sample
Suche in Medline nach
Autoren
-
Pola Hahlweg
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg
-
Levente Kriston
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg
-
Isabelle Scholl
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg
-
Elmar Brähler
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig
-
Herrmann Faller
- Julius-Maximilians-Universität Würzburg, Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften am Institut für Klinische Epidemiologie und Biometrie, Würzburg
-
Holger Schulz
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg
-
Joachim Weis
- Universitätsklinikum Freiburg, Stiftungsprofessur Selbsthilfeforschung, Tumorzentrum Freiburg – CCCF, Freiburg
-
Uwe Koch-Gromus
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg
-
Karl Wegscheider
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Biometrie und Epidemiologie, Hamburg
-
Anja Mehnert
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig
-
Martin Härter
- Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg
| Veröffentlicht: | 12. Oktober 2018 |
|---|
Gliederung
Text
Background: Shared decision-making is especially relevant in cancer care. Previous studies focused on single cancer entities and/or used small samples to gain insight into treatment decision-making processes in oncology.
Aim: The aim of this study was to analyze the preferred and perceived levels of involvement of patients in treatment decision-making from the patients’ perspective in a large-scale and representative sample of German patients with various cancer diagnoses.
Methods: We conducted a multicenter, epidemiological cross-sectional study with a proportional stratified random sample based on the nationwide incidence of all cancer diagnoses in Germany. Patients from acute care hospitals, outpatient cancer care facilities, and cancer rehabilitation clinics in five regions in Germany were included in a consecutive sample of adult cancer patients across all cancer entities and disease stages. The study at hand reports a secondary analysis using the Control Preferences Scale (CPS) assessing the preferred level of involvement in decision-making and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) assessing the perceived level of involvement as outcomes.
Results: 4,020 patients (mean age of 58 years, 51% female) completed the self-report questionnaire. About a third each preferred patient-led, shared, or physician-led decision-making, respectively. 50.7% perceived high levels of shared-decision-making, and about a quarter each reported moderate (26.0%) or low (24.3%) levels of shared decision-making. The concordance between preferred and perceived levels of involvement were found to be statistically significant, but with a very small effect size (p < 0.001, Cramer’s V=0.067). Sex, age, relationship status, education, occupational status, health care setting, and tumor entity were linked to preferred and/or perceived decision-making.
Discussion: The majority of patients with cancer wanted some level of involvement in decision-making. Many patients reported having perceived a high level of shared-decision making. However, there is a considerable proportion of cancer patients that did not perceive their preferred level of involvement.
Practice implications: This large-scale epidemiological study provides a solid basis for implementation efforts for improving shared decision-making in German cancer care.
