期刊
HEALTH EXPECTATIONS
卷 24, 期 5, 页码 1780-1789出版社
WILEY
DOI: 10.1111/hex.13317
关键词
cancer; cancer patient pathway; narrative; Norway; patient participation; shared decision-making; standardization
类别
资金
- University Hospital North Norway - Research Council of Norway [272665]
The implementation of Cancer Patient Pathways (CPPs) in Norway aimed to improve cancer diagnostics and treatment initiation by ensuring standardized waiting times and enhancing patient participation through shared decision-making. This study found that standardized CPPs provided patients with predictability and safety, enabling shared decision-making when cancer diagnoses supported preference-sensitive treatment options. Balancing standardizations with individualized care is key to facilitating patient participation in CPPs.
Background Cancer patient pathways (CPPs) were implemented in Norway in 2015-2017 to advance cancer diagnostics and treatment initiation. The aim of CPPs is to ensure standardized waiting times, but also to strengthen patient participation and shared decision-making. This study investigates how patients enrolled in a CPP experienced shared decision-making. Methods This study comprised of 19 individual semistructured interviews with patients who had been enrolled in a CPP at three hospitals in Norway. Twelve patients had breast cancer, four patients had prostate cancer and three patients had malignant melanoma. We analyzed their experiences using a narrative approach. Findings This study showed how participating in a standardized CPP provided different possibilities for shared decision-making. The patients' narratives of shared decision-making in CPPs included stories from the three cancer diagnoses through the following themes: (1) The predictable safeness of standardizations, (2) the ambivalence of making decisions and (3) opposing standardizations and pushing for action. Conclusion Standardized CPPs provided patients with predictability and safety. Shared decision-making was possible when the cancer diagnoses supported preference-sensitive treatment options. Balancing standardizations with individualized care is necessary to facilitate patient participation in CPPs, and the possibility of shared decision-making needs to be discussed for each specific CPP. Patient or Public Contribution A service user representative from the Norwegian Cancer Society participated in designing this study.
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