• Open Access

Education and role modelling for clinical decisions with female cancer patients

Authors


Prof. Phyllis Butow
Medical Psychology Research Unit
School of Psychology Griffith Taylor Building (A19)
University of Sydney
NSW 2006
Australia
E-mail: phyllisb@psych.usyd.edu.au

Abstract

Background  Patients vary widely in their preferences and capacity for participating in treatment decision-making. There are few interventions targeting patient understanding of how doctors make decisions and shared decision-making. This randomized trial investigates the effects of providing cancer patients with a package designed to facilitate shared decision-making prior to seeing their oncologist.

Patients and methods  Sixty-five female cancer patients were randomized to receive either the package (booklet and 15-min video) or a booklet on living with cancer, before their initial consultation. Participants completed questionnaires prior to the intervention, immediately after the oncology consultation, and 2 weeks and 6 months later. The first consultation with the oncologist was audio-taped and transcribed.

Results  Patients receiving the package were more likely than controls to declare their information and treatment preferences in the consultation, and their perspectives on the costs, side-effects and benefits of treatment. Doctors introduced considerably more new themes in the consultations with intervention subjects than they did with controls; no other differences in doctor behaviour were noted.

Conclusions  This short intervention successfully shifted patient and doctor behaviour closer to the shared decision-making model, although it did not alter patients’ preferences for information or involvement.

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