Through Clinicians Eyes: Use of an In-consultation Patient Decision Aid in Radiation Treatment for Early Breast Cancer: A Qualitative Study

Stine Rauff Søndergaard*, Mette Stie, Troels Bechmann, Birgitte Vrou Offersen, Mette Holck Nielsen, Mette Møller, Leonard L. Berry, Robert Zachariae, Karina Dahl Steffensen, Lea Lund

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Introduction: Shared decision making (SDM) has become a crucial element on the political agenda and represents a vital aspect of modern healthcare. However, successful implementation of SDM highly depends on the attitude of clinicians towards SDM. The overall aim of our study was to explore the experience of oncologists and nurses with SDM using the Decision Helper, an in-consultation decision aid, at four Danish radiotherapy departments. Methods: Semi-structured interviews were conducted with 20 clinicians. The participants were selected using purposive sampling to include nurses and oncologists, male and female, with different levels of experience with SDM and clinical work. The analysis was a data-driven, iterative process with inductive coding of all interviews and meaning condensation. Results: Two main themes emerged: “Using the Decision Helper changes the consultation” and “Change of attitude among Danish oncologists.” Each of the two themes included four elaborative subthemes, which are reported with supporting citations in this paper. In brief, the use of SDM and the Decision Helper should ideally be adjusted to the individual patient and depends highly on the oncologist. The participants described ambitions towards “making the right decision for this patient at this time.” The healthcare system, however, has pitfalls that may hinder SDM, e.g., rigid interpretation of guideline-based recommendations. Conclusion: Using an in-consultation Decision Helper has the potential for individualized, structured patient engagement in decision making. There is a need for patient decision aids in clinical guidelines to ensure patient engagement in decision making.

Original languageEnglish
JournalClinical Breast Cancer
Volume24
Issue number4
Pages (from-to)e297-e309
ISSN1526-8209
DOIs
Publication statusPublished - Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Keywords

  • Adjuvant radiotherapy
  • Shared decision making
  • Patient Participation/psychology
  • Attitude of Health Personnel
  • Humans
  • Middle Aged
  • Decision Support Techniques
  • Breast Neoplasms/radiotherapy
  • Male
  • Physician-Patient Relations
  • Oncologists/psychology
  • Decision Making, Shared
  • Denmark
  • Female
  • Adult
  • Referral and Consultation
  • Qualitative Research

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