A matter of trust – patient's views on decision‐making in colorectal cancer

Health Expectations - Tập 7 Số 2 - Trang 104-114 - 2004
Glenn Salkeld1, Michael J. Solomon2, Leonie Short3, Phyllis Butow4
1School of Public Health and Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, The University of Sydney, Camperdown, NSW, Australia.
2Associate Professor, Department of Colorectal Surgery and Surgical Outcomes Research Centre (SOuRCe), The University of Sydney, NSW
3Honorary Research Fellow, Centre for Public Health, Queensland University of Technology, Kelvin Grove, Queensland
4Associate Professor, Medical Psychology Unit and Surgical Outcomes Research Centre (SOuRCe), The University of Sydney, NSW, Australia

Tóm tắt

AbstractObjectives To determine which aspects of the treatment decision process, therapy and outcomes are most important to patients with colorectal cancer (CRC).Design Cross‐sectional survey.Participants A total of 102 men and 73 women who had completed primary treatment for CRC in two teaching hospitals in Central Sydney, Australia.Main outcomes measures Patient's rating of the importance of the decision‐making aspects and outcomes of treatment for CRC.Results Trust in their surgeon and confidence of specialty training are of paramount importance to CRC patients. Patients also have a strong desire to get on with treatment quickly and rate the risk of disease recurrence and quality of life as being very important in their treatment decisions. Gender, age and whether the patient had undergone adjuvant radiotherapy were all significant predictors of preferred mode of treatment decision‐making. Fifty‐eight per cent of women preferred a shared decision‐making role compared with 36% of men, whilst older patients and those who had undergone adjuvant radiotherapy were significantly more likely to prefer that their surgeon decide upon treatment when compared with younger patients and respondents who have not had radiotherapy.Conclusions Regardless of whether a patient prefers an active or more passive role in decision‐making, having a surgeon explain treatment options in a clear, unhurried and open manner is vital to how patients feel about their treatment. Whilst acknowledging that individual patients will have different needs for information and preferences for treatment, there are several factors amongst many in the process of decision‐making which are considered very important by patients with CRC. A surgeon who adopts a consultation style that is open and informative, that offers patients the chance to participate in the process of decision‐making and clearly explain treatment options and outcomes will engender trust with their patient.

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Tài liệu tham khảo

10.1046/j.1369-6513.2002.00198.x

10.1007/s10350-004-6749-0

EdwardsA ElwynG.Evidence‐based Patient Choice.Oxford: Oxford University Press 2001.

10.1046/j.1369-6513.2002.00193_2.x

10.1002/cncr.10393

10.1002/pon.566

10.1016/S0277-9536(00)00303-8

10.1046/j.1369-6513.1999.00066.x

Bain N, 2002, Striking the right balance in colorectal cancer care – a qualitative study of rural and urban patients, Family Practice, 19, 369, 10.1093/fampra/19.4.369

10.1046/j.1523-5394.2000.81012.x

10.1111/j.1467-842X.2000.tb01615.x

Degner L, 1997, The control preferences scale, Canadian Journal of Nursing Research, 29, 21

Statistical Package for the Social Sciences. Chicago 1989.

Cattell RB., 1966, Handbook of Multivariate Experimental Psychology

Zwick W, 1986, Comparison of five rules for the number of components to retain, Psychological Medicine, 99, 432

Fallowfield LJ, 1994, Psychological effects of being offered choice of surgery for breast cancer, Social Science and Medicine, 309, 448

10.1016/0960-9776(94)90046-9

10.1046/j.1369-6513.2002.00194.x

10.1136/bmj.320.7239.909

10.1200/JCO.2001.19.1.72

Little M, 1999, Vulnerability in the narratives of patients and their carers – studies of colorectal cancer, 1

10.1111/1467-9566.00081

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Health Expectations

Tập 7 Số 2

104-114

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