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Patient Participation in Deciding Breast Cancer Treatment and Subsequent Quality of Life
Abstract
This investigation of patients with early breast cancer examined relationships among patient involvement in deciding treatment (i.e., whether to undergo breast removal or breast conservation), perceptions of control over treatment decisions, and subsequent health-related quality of life. It was predicted 1) that patients who more actively participated in consultations to decide treatment would perceive more decision control than would more passive patients and 2) that patients who perceived greater decision control would report better health-related quality of life following treatment than would patients perceiving less decision control. Sixty patients with stage I or II breast cancer allowed their consultations with surgeons to be audiorecorded. Following these visits, patients reported on their involvement in the consultation, optimism for the future, knowledge about treatment, and two aspects of perceived decision control, the perception of having a choice for treatment and the extent to which the doctor or patient was responsible for the decision. Six and 12 months postoperatively, 51 patients (85%) returned a follow-up survey assessing perceived decision control and health-related quality of life. The first prediction received some support. The patients who had more actively participated in their consultations, particularly in terms of offering opinions, assumed more responsibility for treatment decisions during the year following surgery than did less expressive patient…
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“Research suggests that patient participation is linked to positive patient outcomes such as improved quality of life, reduced anxiety and depression, greater satisfaction, better sharing of information, and better treatment adherence (6)(7)(8)(9).”
From High levels of socioeconomic deprivation do not inhibit patients’ communication of concerns in head and neck cancer review clinics (2018) · cites this paper as [8]
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“Nonetheless, building rapport is an important aspect of clinical communication with a number of benefits for patients (5,(7)(8)(9), and low SES patients may be placed at a disadvantage if less time is spent building rapport.”
From High levels of socioeconomic deprivation do not inhibit patients’ communication of concerns in head and neck cancer review clinics (2018) · cites this paper as [8]
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“It is important to understand the needs of these patients in order to inform shared decision-making, which in turn can improve engagement, patient satisfaction, [11] quality of life, [12,13] and health outcomes [14].”
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“Made best decision possible — — 6 (4) 66 (44) 79 (52) Decision consistent with values — — 3 (2) 63 (42) 85 (56)”
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“[56] It is unclear whether shared decision-making can be combined with implementation of evidence-based practice, because patients may prefer treatments which are not evidence based or where the evidence on effectiveness is negative.”
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“More patients are engaged in the decision process of treatment in this digital age where patients become more educated and more sophisticated researchers on the benefits and risks of their therapy.(15,19,32) In particular, there is a lot of room for patient involvement during IBD treatment due to the uncertainty of th…”
BackgroundDecision Making About Treatment of Hypothetical Prostate Cancer
Steginga, S., & Occhipinti, S. (2002) · Journal of Psychosocial Oncology · doi:10.1300/j077v20n03_05 · Cited by 18
“For example, prospective studies of decision making among women with breast cancer have failed to find significant relationships between perceived decisional control and choice at the time of treatment and later adjustment (Stanton et al., 1998; Street & Voight, 1997).”
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Breast cancer and menopause: perceptions of diagnosis, menopausal therapies and health behaviors
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“Although the specific impact of this knowledge has not been studied in breast cancer populations, limited cancer knowledge may impact screening [18–20], cancerrelated outcomes [9, 17, 21–25], and satisfaction with care [10, 26, 27].”
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Oncology Residents’ Perspectives on Communication Skills and Shared Decision Making
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“Various empirical studies in cancer and other chronic illnesses confirm that patients who have higher perceptions of self-efficacy and competence are more likely to succeed in self-care activities and report better health outcomes.(48,49) Patients who are active in managing their health and illness are also active in…”
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Helping patients make choices about breast reconstruction: A decision analysis approach
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“A graphic narrative panel is included for each of the following steps in the radiation therapy treatment process: (1) consult, (2) simulation, (3) planning, (4) treatment, and (5) follow-up.”
MethodPatient engagement: qualitative narratives illustrate patient engagement behaviors
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Patients' Perceptions of Physician-Patient Discussions and Adverse Events with Cancer Therapy
Hershman, D., Calhoun, E., Zapert, K., Wade, S., Malin, J., & Barron, R. (2008) · Archives of Drug Information · doi:10.1111/j.1753-5174.2008.00011.x · Cited by 13
Cancer Diagnosis Disclosure in a Northern Italian Hospital Report on 312 Consecutive Cancer Patients
Cavanna, L., Anselmi, E., Lazzaro, A., Seghini, P., di Nunzio, C., Dallanegra, L., & Monfredo, M. (2007) · Tumori · doi:10.1177/030089160709300311 · Cited by 13
Surgeon Perspectives on Surgical Options for Early-Stage Breast Cancer
Thompson, T. A., Pusic, A., Kerrigan, C., Sargeant, R., Slezak, S. S., Chang, B., Helzlsouer, K., & Manson, P. (2000) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-200003000-00013 · Cited by 13
Less reduction of psychosocial problems among adolescents with unmet communication needs
Jager, M., Reijneveld, S., Almansa, J., Metselaar, J., Knorth, E., & de Winter, A. D. (2016) · European Child and Adolescent Psychiatry · doi:10.1007/s00787-016-0901-y · Cited by 12
“Patient-centered communication has been shown to be associated with improvements in adherence, satisfaction, and health outcomes in various types of health care such as general practice, oncology and diabetes care [10–15].”
BackgroundThe Patient Experience With Shared Decision Making: A Qualitative Descriptive Study
Truglio‐Londrigan, M. (2015) · Journal of Infusion Nursing · doi:10.1097/nan.0000000000000136 · Cited by 12
Tallarico, M., Figueiredo, M. I., Goodman, M., Kreling, B., & Mandelblatt, J. (2005) · Cancer Journal · doi:10.1097/00130404-200511000-00011 · Cited by 12
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“18–20 The latest American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) and European Society of Cardiology (ESC) guidelines for management of patients with AF recommend SDM for decisions surrounding anticoagulant use.”
BackgroundJaakkola, E. (2007) · Health Services Management Research · doi:10.1258/095148407781395937 · Cited by 11
Preferences for involvement in medical decision making: Comparing British and German views
Rüdell, K., Myers, L. B., & Newman, S. (2006) · Psychology, Health & Medicine · doi:10.1080/13548500500357026 · Cited by 11
“Patient involvement in medical decision making (MDM) is gaining more importance in medical practice as evidence shows that patients who actively participate in decisions about their medical care have more beneficial outcomes than patients who have no involvement (Brody, Miller, Lerman, Smith, & Caputo, 1989 ; Fallowfi…”
BackgroundPatient preferences in treatment options of ulcerative colitis: a discrete choice experiment
Straatmijer, T., Marle, M. E. V. D. A., Ponsioen, C. Y., van der Horst, D., Scherpenzeel, M., Duijvestein, M., & Jong, A. E. V. D. M. (2023) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2023.2286191 · Cited by 11
“Also, studies suggest that patients who participate more actively in their care are more satisfied with medical services provided and may have better health outcomes [7, 8].”
BackgroundLee, H. J., Qian, C., Landay, S. L., O'Callaghan, D., Kaslow-Zieve, E., Azoba, C. C., Fuh, C.-X., Temel, B., Ufere, N., Petrillo, L., et al. (2021) · JCO Oncology Practice · doi:10.1200/op.21.00388 · Cited by 10
Solitano, V., Vuitton, L., Peyrin‐Biroulet, L., & Danese, S. (2021) · Gastroenterology · doi:10.1053/j.gastro.2021.03.038 · Cited by 11
Delivering Bad News in Amyotrophic Lateral Sclerosis
Edwards, W. F., Malik, S., Peters, J., Chippendale, I., & Ravits, J. (2020) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000000957 · Cited by 16
Lapedis, C. J., Horowitz, J., Brown, L., Tolle, B. E., Smith, L. B., & Owens, S. (2020) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2019-0105-oa · Cited by 10
Attitudes of Persons With Physical Disabilities Toward Physician-Assisted Death
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Wei, Y., Ming, J., Shi, L., Ke, X., Sun, H., & Chen, Y. (2020) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462320000719 · Cited by 12
“Many healthcare providers, patients, ethicists, medical educators, and researchers have advocated the importance of SDM, which may positively impact patients in a number of ways; such as increased patient satisfaction (14–16), better adherence to treatments (15, 17) better control of diseases, better quality of life (…”
BackgroundExceptional patients and communication in cancer care—are we missing another survival factor?
Frenkel, M., Engebretson, J., Gross, S., Peterson, N. E., Giveon, A. P., Sapire, K., & Hermoni, D. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-016-3255-6 · Cited by 9
Understanding quality of life for children after liver transplantation: A work in progress
Ng, V., & Otley, A. (2008) · Liver transplantation · doi:10.1002/lt.21430 · Cited by 9
“Assessment of HRQOL permits us to hear the voice and perspective of the patient, which can predict, often better than physiologic measures, future health status, mortality, and resource utilization.(20,21) Given the varying perceptions and expectations between individuals, two people with the same health status may ha…”
BackgroundGaisser, A., & Stamatiadis-Smidt, H. (2004) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-004-0913-5 · Cited by 11
Knowledge model reuse: therapy decision through specialisation of a generic decision model
Manjarrés, Á., Pickin, S., & Mira, J. (2002) · Expert systems with applications · doi:10.1016/s0957-4174(02)00031-3 · Cited by 9
Vohra, Y., Brown, C. M., Moczygemba, L. R., & Wilfong, L. S. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-07632-7 · Cited by 10
“1 3 patients at lower activation levels were poor managers of their health and experienced poor HRQOL [18, 21, 31].”
BackgroundPatient-centered Involvement in Decision-Making
Perkins, H. S., Freed, A. A., Cortez, J., & Hazuda, H. (2019) · Medical Care · doi:10.1097/mlr.0000000000001132 · Cited by 8
Experiencing cancer treatment decision-making in managed care.
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Health-related quality of life in liver transplant recipients
Bucuvalas, J., & Alonso, E. (2005) · doi:10.1097/01.mot.0000163043.71825.cf · Cited by 8
Patient Participation and Decision Control
de Haes, H. D., & Molenaar, S. (1997) · Medical decision making · doi:10.1177/0272989x9701700314 · Cited by 8
Metadata
- Authors
- Street, R. L., & Voigt, B.
- Affiliations
- Texas A&M University (US)
- ORCID
- Street, Richard L.
- Venue
- Medical Decision Making
- Publisher
- SAGE Publications
- Published
- 1997-07
- Volume
- 17
- Issue
- 3
- Pages
- 298-306
- ISSN
- 0272-989X (ISSN-L)
- 1552-681X
- OpenAlex
- W1986448046
- Cited by
- 258
- References
- 0
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 7 · 2019: 5 · 2018: 9 · 2017: 9 · 2016: 12 · 2015: 15 · 2014: 7 · 2013: 12 · 2012: 10
- FWCI
- 16.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Decision Making (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- patient participation, shared decision-making, breast cancer, early breast cancer, health-related quality of life, breast-conserving therapy, mastectomy, physician-patient consultation, treatment selection
- MeSH terms
- Adult, Aged, Aged, 80 and over, Breast Neoplasms, Decision Support Techniques, Female, Follow-Up Studies, Humans, Internal-External Control, Middle Aged, Patient Care Team, Patient Participation, Quality of Life, Mastectomy, Segmental, Treatment Outcome, Patient Satisfaction
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