Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

Purpose. We investigated 1) perceived roles in decision-making among advanced cancer patients in 5 Asian countries 2) associations of patient characteristics with these roles, and 3) the association of perceived roles with quality of life and perceived quality of care. Methods. We surveyed 1585 pati...

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Autores principales:	Semra Ozdemir, Chetna Malhotra, Irene Teo, Si Ning Germaine Tan, Wei Han Melvin Wong, Anjum S. Khan Joad, Thushari Hapuarachchi, Gayatri Palat, Pham Nguyen Tuong, Sushma Bhatnagar, Rubayat Rahman, Lubna Mariam, Xiaohong Ning, Eric Andrew Finkelstein
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/c1a8adfbfaf541668e48e5eb6e225cc5
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spelling	oai:doaj.org-article:c1a8adfbfaf541668e48e5eb6e225cc52021-11-19T22:33:30ZPatient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study2381-468310.1177/23814683211061398https://doaj.org/article/c1a8adfbfaf541668e48e5eb6e225cc52021-11-01T00:00:00Zhttps://doi.org/10.1177/23814683211061398https://doaj.org/toc/2381-4683Purpose. We investigated 1) perceived roles in decision-making among advanced cancer patients in 5 Asian countries 2) associations of patient characteristics with these roles, and 3) the association of perceived roles with quality of life and perceived quality of care. Methods. We surveyed 1585 patients with stage IV solid cancer. Multinomial logistic regressions were used to analyze associations of patient characteristics with decision-making roles. Multivariate regressions were used to analyze associations of decision-making roles with quality of life and care. Results. The most common perceived-role was no patient involvement. Most patients (73%) reported roles consistent with their preferences. Being male, nonminority, higher educated, aware of advanced cancer diagnosis, and knowledge of cancer diagnosis for ≥1 year were associated with higher levels of patient involvement in decision-making. Compared to no patient involvement, joint decision-making (together with physicians/family) was associated with higher social (β = 2.49, P < 0.01) and spiritual (β = 2.64, P < 0.01) well-being, and better quality of physician communication (β = 9.73, P < 0.01) and care coordination (β = 13.96, P < 0.01) while making decisions alone was associated with lower emotional (β = −1.43, P < 0.01), social (β = −2.39, P < 0.01), and spiritual (β = −2.98, P < 0.01) well-being. Conclusions. Findings suggest that a substantial number of advanced cancer patients were not (and preferred not to be) involved in decision-making. Despite this finding, joint decision-making together with physicians/family was associated with better quality of life and care. Implications. Physicians should explain the benefits of shared decision making to patients and encourage participation in decision-making, while ensuring that patients feel supported and do not find decision-making overwhelming.Semra OzdemirChetna MalhotraIrene TeoSi Ning Germaine TanWei Han Melvin WongAnjum S. Khan JoadThushari HapuarachchiGayatri PalatPham Nguyen TuongSushma BhatnagarRubayat RahmanLubna MariamXiaohong NingEric Andrew FinkelsteinSAGE PublishingarticleMedicine (General)R5-920ENMDM Policy & Practice, Vol 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Semra Ozdemir Chetna Malhotra Irene Teo Si Ning Germaine Tan Wei Han Melvin Wong Anjum S. Khan Joad Thushari Hapuarachchi Gayatri Palat Pham Nguyen Tuong Sushma Bhatnagar Rubayat Rahman Lubna Mariam Xiaohong Ning Eric Andrew Finkelstein Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study
description	Purpose. We investigated 1) perceived roles in decision-making among advanced cancer patients in 5 Asian countries 2) associations of patient characteristics with these roles, and 3) the association of perceived roles with quality of life and perceived quality of care. Methods. We surveyed 1585 patients with stage IV solid cancer. Multinomial logistic regressions were used to analyze associations of patient characteristics with decision-making roles. Multivariate regressions were used to analyze associations of decision-making roles with quality of life and care. Results. The most common perceived-role was no patient involvement. Most patients (73%) reported roles consistent with their preferences. Being male, nonminority, higher educated, aware of advanced cancer diagnosis, and knowledge of cancer diagnosis for ≥1 year were associated with higher levels of patient involvement in decision-making. Compared to no patient involvement, joint decision-making (together with physicians/family) was associated with higher social (β = 2.49, P < 0.01) and spiritual (β = 2.64, P < 0.01) well-being, and better quality of physician communication (β = 9.73, P < 0.01) and care coordination (β = 13.96, P < 0.01) while making decisions alone was associated with lower emotional (β = −1.43, P < 0.01), social (β = −2.39, P < 0.01), and spiritual (β = −2.98, P < 0.01) well-being. Conclusions. Findings suggest that a substantial number of advanced cancer patients were not (and preferred not to be) involved in decision-making. Despite this finding, joint decision-making together with physicians/family was associated with better quality of life and care. Implications. Physicians should explain the benefits of shared decision making to patients and encourage participation in decision-making, while ensuring that patients feel supported and do not find decision-making overwhelming.
format	article
author	Semra Ozdemir Chetna Malhotra Irene Teo Si Ning Germaine Tan Wei Han Melvin Wong Anjum S. Khan Joad Thushari Hapuarachchi Gayatri Palat Pham Nguyen Tuong Sushma Bhatnagar Rubayat Rahman Lubna Mariam Xiaohong Ning Eric Andrew Finkelstein
author_facet	Semra Ozdemir Chetna Malhotra Irene Teo Si Ning Germaine Tan Wei Han Melvin Wong Anjum S. Khan Joad Thushari Hapuarachchi Gayatri Palat Pham Nguyen Tuong Sushma Bhatnagar Rubayat Rahman Lubna Mariam Xiaohong Ning Eric Andrew Finkelstein
author_sort	Semra Ozdemir
title	Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study
title_short	Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study
title_full	Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study
title_fullStr	Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study
title_full_unstemmed	Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study
title_sort	patient-reported roles in decision-making among asian patients with advanced cancer: a multicountry study
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/c1a8adfbfaf541668e48e5eb6e225cc5
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Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

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