Observing the Implementation of Shared Decision-making in Routine Radiotherapy Cancer Nursing : An Explorative Longitudinal Questionnaire Study

• BackgroundHealthcare professionals have driven decision-making in the past. However, shared decision-making has the potential to increase quality of care.ObjectiveTo determine to what degree patients undergoing routine pelvic radiotherapy care perceive decision-making as being shared between patient and healthcare professionals.MethodsThis 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.ResultsThe 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).ConclusionsAlmost 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.ImplicationsHealthcare professionals may need to pay extra attention to patients who may perceive that they share decision-making to a low extent.This study was supported by the Swedish Cancer Society, the Vårdal Institute, the Cancer Rehabilitation Foundation, the County Council of Östergötland, and Linköping University, Sweden. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)

Nyckelord

Cancer nursing

Communication

Decision-making

Implementation

Oncology nursing

Patient involvement

Patient-reported outcomes

Quality of life

Radiotherapy

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