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Oncologist‐patient‐caregiver decision‐making discussions in the context of advanced cancer in an Asian setting

Bibliographic Data

ID19508258
AuthorsCHETNA MALHOTRA (0000-0002-5380-0525, Lien Centre for Palliative Care Duke‐NUS Medical School Singapore Singapore, corresponding author), Ravindran Kanesvaran (0000-0002-2351-881X, National Cancer Centre Singapore Singapore Singapore), Nesaretnam Barr Kumarakulasinghe (National University Cancer Institute Singapore (NCIS) National University Health System Singapore Singapore), Sing‐Huang Tan (OncoCare Cancer Centre Gleneagles Medical Centre Singapore Singapore), Ling Xiang (0009-0004-7645-3900, Lien Centre for Palliative Care Duke‐NUS Medical School Singapore Singapore), James A Tulsky (0000-0002-7458-0453, Dana‐Farber Cancer Institute Boston MA USA), Kathryn I Pollak (0000-0002-5559-2416, Cancer Control and Population Sciences Duke University Durham NC USA)
Year2020
Volume23
Issue1
Pages220-228
Publication date2020-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.12994
PMID31682064
OpenAlexW2982717304
LanguageEN
Citations received3
References cited45

OBJECTIVE: Patient involvement in treatment decisions is recommended in clinician-patient encounters. Little is known about how oncologists engage patients in shared decision making in non-Western countries. We assessed the prevalence of shared decision making among Singaporean oncologists and analysed how they discussed prognosis. METHODS: We audio-recorded 100 consultations between advanced cancer patients and their oncologists. We developed a coding system to assess oncologist encouragement of patient participation in decision making and disclosure of an explicit prognosis. We assessed patient and oncologist characteristics that predicted these behaviours. RESULTS: Forty-one consultations involved treatment discussions. Oncologists almost always listed more than one treatment option (90%). They also checked patient understanding (34%), discussed pros and cons (34%) and addressed uncertainty (29%). Oncologists discussed prognosis mostly qualitatively (34%) rather than explicitly (17%). They were more likely to give an explicit prognosis when patients/caregivers asked questions related to prognosis. CONCLUSION: Oncologists in our sample engaged their patients in decision making. They have areas in which they can improve to involve patients at a deeper level to ensure shared decision making. Findings will be used to develop an intervention targeting oncologists and patients to promote patient involvement in decision making

Alternative medicine · Decision aids · Family medicine · MEDLINE · Pathology · Patient participation · Cancer survivorship and care · Medicine · Nursing · Palliative Care and End-of-Life Issues · Patient-Provider Communication in Healthcare · Internal Medicine · Oncology

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Unique citing works3
Citations per year0,5
Citation span2020 - 2022 (3)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2

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