Wendy W T Lam1, Marie Kwok2, Miranda Chan3, Wai Ka Hung3, Marcus Ying3, Amy Or3, Ava Kwong4, Dacita Suen4, Sungwon Yoon2, Richard Fielding2. 1. School of Public Health, The University of Hong Kong, Hong Kong. Electronic address: wwtlam@hku.hk. 2. School of Public Health, The University of Hong Kong, Hong Kong. 3. The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong. 4. Breast Surgery Division, Department of Surgery, The University of Hong Kong, Hong Kong.
Abstract
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.
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.
Authors: Masoud Bahrami; Mahboobeh Namnabati; Fariborz Mokarian; Parastoo Oujian; Paul Arbon Journal: Support Care Cancer Date: 2017-01-11 Impact factor: 3.603
Authors: Caitriona Cahir; Stephan U Dombrowski; Catherine M Kelly; M John Kennedy; Kathleen Bennett; Linda Sharp Journal: Support Care Cancer Date: 2015-03-07 Impact factor: 3.603
Authors: Felisa A Gonzales; Meera Sangaramoorthy; Laura A Dwyer; Salma Shariff-Marco; Amani M Allen; Allison W Kurian; Juan Yang; Michelle M Langer; Laura Allen; Bryce B Reeve; Stephen H Taplin; Scarlett Lin Gomez Journal: J Cancer Surviv Date: 2019-10-23 Impact factor: 4.442
Authors: Jennifer W H Shum; Wendy W T Lam; Bonnie N K Choy; Jonathan C H Chan; Wing Lau Ho; Jimmy S M Lai Journal: BMJ Open Ophthalmol Date: 2017-12-14
Authors: Wendy W T Lam; Ava Kwong; Dacita Suen; Janice Tsang; Inda Soong; Tze Kok Yau; Winnie Yeo; Joyce Suen; Wing Ming Ho; Ka Yan Wong; Wing Kin Sze; Alice W Y Ng; Richard Fielding Journal: BMC Cancer Date: 2018-02-07 Impact factor: 4.430