Shared decision making in adjuvant cancer treatment

Leiden Repository

Shared decision making in adjuvant cancer treatment

Type: Doctoral Thesis
Title: Shared decision making in adjuvant cancer treatment
Author: Kunneman- van Unnik, Helena Josefina Antonia Maria (Marleen)
Publisher: Department of Medical Decision Making, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2016-02-25
Keywords: Shared decision making
Communication
Oncology
Patient preferences
Abstract: In this thesis, we aimed to gain insight in the process of shared decision making in the setting of adjuvant cancer treatments. We observed clinician-patient consultations in daily clinical practice, and developed a core list of information that should be provided in the pre-treatment consultation. We showed that the three key steps of shared decision making are followed to a limited extent. Choice awareness is rarely created in pre-treatment consultations on (neo-)adjuvant cancer treatment, and the option of foregoing these treatments is omitted consistently (Step 1). There is large variation in information provision on possible treatment strategies. Patients tend to overestimate the beneficial effect of treatment, and to underestimate the probability of harms (Step 2). Finally, patients’ values and treatment preferences are elicited in only a minority of consultations. If patients voice their values or treatment preferences, or if the oncologist indicates to consider these, patients perceive a significant more active role in the decision making process (Step 3). Our results show that opportunities are missed to engage patients in a process of shared decision making. Small changes in doctor-patient communication can facilitate patients’ involvement in deciding about treatment.
Description: Promotores: A.M. Stiggelbout, C.A.M. Marijnen, Co-Promotor: A.H. Pieterse
With Summary in Dutch
Faculty: LUMC
Citation: Kunneman-van Unnik, H.J.A.M., 2016, Doctoral Thesis, Leiden University
ISBN: 9789090294797
Sponsor: KWF Kankerbestrijding
Handle: http://hdl.handle.net/1887/38221
 

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