Keywords

Cancer nursing, Communication, Decision-making, Implementation, Oncology nursing, Patient involvement, Patient-reported outcomes, Quality of life, Radiotherapy

 

Authors

  1. Efverman, Anna PhD, RP
  2. Bergius Axelsson, Beata RN

Abstract

Background: Healthcare professionals have driven decision-making in the past. However, shared decision-making has the potential to increase quality of care.

 

Objective: To determine to what degree patients undergoing routine pelvic radiotherapy care perceive decision-making as being shared between patient and healthcare professionals.

 

Methods: This exploratory longitudinal study covered 193 patients undergoing pelvic radiotherapy, mostly women (n = 161 [84%]) treated for a gynecological (n = 132 [68%]) or colorectal (n = 54 [28%]) cancer. We collected data regarding self-perceived level of shared decision-making at the start of radiotherapy and quality of life (QoL) (91%-95% response rate per week) during the radiotherapy period.

 

Results: The patients reported that they shared the decision-making with the healthcare professionals much (n = 137 [71%]), moderately (n = 33 [17%]), a little (n = 12 [6%]), or not at all (n = 11 [6%]). Male patients (P = .048), patients who did not live with their partner (P = .034), patients with higher education (P = .043), and patients with low functional capacity (P = .018) perceived lower levels of shared decision-making. A higher level of shared decision-making was related to higher QoL at baseline and during the first to third weeks of radiotherapy (P ranged from .001 to .044).

 

Conclusions: Almost 9 of 10 patients reported that they shared the decision-making moderately or much with the healthcare professionals. The study identified subgroups perceiving lower levels of shared decision-making and found that a higher level of shared decision-making was related to better QoL.

 

Implications: Healthcare professionals may need to pay extra attention to patients who may perceive that they share decision-making to a low extent.