Pola Hahlweg1,2, Levente Kriston1,2, Isabelle Scholl1,2, Elmar Brähler3,4, Hermann Faller5, Holger Schulz1,2, Joachim Weis6, Uwe Koch1,2, Karl Wegscheider2,7, Anja Mehnert3, Martin Härter1,2. 1. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 2. Center of Health Care Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany. 4. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 5. Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany. 6. Professor for Self-Help Research, Comprehensive Cancer Center, University of Freiburg, Freiburg, Germany. 7. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract
Background: We aimed to analyze preferred and perceived levels of patients' involvement in treatment decision-making in a representative sample of cancer patients.Material and Methods: We conducted a multicenter, epidemiological cross-sectional study with a stratified random sample based on the incidence of cancer diagnoses in Germany. Data were collected between January 2008 and December 2010. Analyses were undertaken between 2017 and 2019. We included 5889 adult cancer patients across all cancer entities and disease stages from 30 acute care hospitals, outpatient facilities, and cancer rehabilitation clinics in five regions in Germany. We used the Control Preferences Scale to assess the preferred level of involvement and the nine-item Shared Decision-Making Questionnaire to assess the perceived level of involvement. Results: About 4020 patients (mean age of 58 years, 51% female) completed the survey. Response rate was 68.3%. About a third each preferred patient-led, shared, or physician-led decision-making. About 50.7% perceived high levels, about a quarter each reported moderate (26.0%) or low (24.3%) levels of shared decision-making. Sex, age, relationship status, education, health care setting, and tumor entity were linked to preferred and/or perceived decision-making. Of those patients who preferred active involvement, about 50% perceived high levels of shared decision-making. Conclusion: The majority of patients with cancer wanted to be involved in medical decisions. Many patients perceived a high level of shared decision-making. However, many patients' level of involvement did not fit their preference. This study provides a solid basis for efforts to improve shared decision-making in German cancer care.
Background: We aimed to analyze preferred and perceived levels of patients' involvement in treatment decision-making in a representative sample of cancerpatients.Material and Methods: We conducted a multicenter, epidemiological cross-sectional study with a stratified random sample based on the incidence of cancer diagnoses in Germany. Data were collected between January 2008 and December 2010. Analyses were undertaken between 2017 and 2019. We included 5889 adult cancerpatients across all cancer entities and disease stages from 30 acute care hospitals, outpatient facilities, and cancer rehabilitation clinics in five regions in Germany. We used the Control Preferences Scale to assess the preferred level of involvement and the nine-item Shared Decision-Making Questionnaire to assess the perceived level of involvement. Results: About 4020 patients (mean age of 58 years, 51% female) completed the survey. Response rate was 68.3%. About a third each preferred patient-led, shared, or physician-led decision-making. About 50.7% perceived high levels, about a quarter each reported moderate (26.0%) or low (24.3%) levels of shared decision-making. Sex, age, relationship status, education, health care setting, and tumor entity were linked to preferred and/or perceived decision-making. Of those patients who preferred active involvement, about 50% perceived high levels of shared decision-making. Conclusion: The majority of patients with cancer wanted to be involved in medical decisions. Many patients perceived a high level of shared decision-making. However, many patients' level of involvement did not fit their preference. This study provides a solid basis for efforts to improve shared decision-making in German cancer care.
Authors: Christoph A Mallmann; Christian M Domröse; Lars Schröder; David Engelhardt; Frederik Bach; Helena Rueckel; Alina Abramian; Christina Kaiser; Alexander Mustea; Andree Faridi; Wolfram Malter; Peter Mallmann; Christian Rudlowski; Oliver Zivanovic; Michael R Mallmann Journal: JMIR Cancer Date: 2021-11-18
Authors: Anne Katrine Skjølstrup Toftdahl; Laura Hvidaa Hjoernholm; Mia Simonsen; Christina M Stapelfeldt; Janus Laust Thomsen; Marianne Kongsgaard; Allan Riis Journal: BMJ Open Date: 2022-04-15 Impact factor: 3.006
Authors: Anja Lindig; Pola Hahlweg; Eva Christalle; Anik Giguere; Martin Härter; Olaf von dem Knesebeck; Isabelle Scholl Journal: BMC Health Serv Res Date: 2021-06-02 Impact factor: 2.655
Authors: Bodil Westman; Karin Bergkvist; Andreas Karlsson Rosenblad; Lena Sharp; Mia Bergenmar Journal: Health Expect Date: 2022-01-20 Impact factor: 3.318
Authors: Anja K Köther; Björn Büdenbender; Britta Grüne; Sonja Holbach; Johannes Huber; Nicolas von Landenberg; Julia Lenk; Thomas Martini; Maurice S Michel; Maximilian C Kriegmair; Georg W Alpers Journal: Cancer Med Date: 2022-03-24 Impact factor: 4.711