期刊
PATIENT EDUCATION AND COUNSELING
卷 94, 期 2, 页码 243-249出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2013.11.006
关键词
Shared decision making; Breast surgical consultation; Breast cancer; Chinese
资金
- Hong Kong Cancer Fund
- Health Services Research Fund [07080651]
- Food and Health Bureau
- Government of Hong Kong, SAR
Objective: To assess the extent to which breast surgical consultations used shared decision making (SDM), identify factors associated with use of SDM, and assess if using SDM increases decision-making satisfaction. Methods: Two hundred and eighty-three video-recorded diagnostic-treatment decision consultations between breast surgeons and women with breast cancer were assessed using the Decision Analysis System for Oncology (DAS-O) coding system designed for assessing SDM behaviors. Women completed a questionnaire at pre-consultation, one-week post-consultation and one-month post-surgery. Patient outcomes included decision conflict, patient satisfaction with medical consultation, and decision regret. Results: Overall, the level of SDM behaviors was low. The extent of SDM behavior within consultation was related to greater consultation duration (p < 0.001), more than one treatment being offered (p <0.001), and fewer questions raised by patients/companions (p <0.05). While use of SDM consultation did not influence post-consultation decision conflict, it increased satisfaction with information given and explained, patients' feelings of trust and confidence in their surgeons, and reduced post-surgical decision regret. Conclusion: These breast surgical consultations mostly adopted informed treatment decision-making approaches. Using SDM improved patient consultation and decision satisfaction. Practice implications: The study findings highlight a need to reinforce the importance of SDM in consultations among breast surgeons. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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