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Trust but Verify: Exploring the Role of Treatment-Related Information and Patient-Physician Trust in Shared Decision Making Among Patients with Metastatic Breast Cancer

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Abstract

An ideal model for decision making in cancer is shared decision-making (SDM). Primary facilitators in this model are information-seeking about treatment options and patient-physician trust. Previous studies have investigated the role of each of these parameters individually. However, little is known about their convergent role in treatment decision-making. Therefore, we explored perspectives of metastatic breast cancer (MBC) patients and healthcare professionals about the influence of health information-seeking and physician trust in the SDM process. Qualitative interviews with 20 MBC patients and 6 community oncologists, as well as 3 separate focus groups involving lay navigators, nurses, and academic oncologists, were conducted, recorded, and transcribed. Qualitative data analysis employed a content analysis approach, which included a constant comparative method to generate themes from the transcribed textual data. Five emergent themes were identified (1) physicians considered themselves as the patients’ primary source of treatment information; (2) patients trusted their physician’s treatment recommendations; (3) patients varied in their approach to seeking further health information regarding the discussed treatment options (e.g., internet websites, family and friends, support groups); (4) other healthcare professionals were cognizant of their fundamental role in facilitating further information-seeking; and (5) patient and physician discordant perspectives on shared decision making were present. Patient procurement of treatment information and the capacity to use it effectively in conjunction with patient trust in physicians play an important role in the shared decision-making process.

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References

  1. Chassin, Mark R, and Robert W. Galvin (1998) The urgent need to improve health care quality: Institute of Medicine National Roundtable on Health Care Quality. Jama 280, no. 11:1000–1005

  2. To Err Is Human: Building a Safer Health System (2000). Institute of Medicine 112

  3. Wise, Jacqui (2011) Shared decision making must move from rhetoric to reality, says King’s Fund d47344

  4. Mulley, Albert G, Chris Trimble, and Glyn Elwyn (2012) Stop the silent misdiagnosis: patients’ preferences matter. Bmj 345:e6572.5

  5. Kindig, David A, Allison M. Panzer, and Lynn Nielsen-Bohlman (eds) (2004) Health literacy: a prescription to end confusion. National Academies Press

  6. Stacey D et al (2017) Shared decision making interventions: theoretical and empirical evidence with implications for health literacy. Stud Health Technol Inform 240:263–283

    PubMed  Google Scholar 

  7. Shen, Hsiu-Nien, Chia-Chen Lin, Tammy Hoffmann, Chia-Yin Tsai, Wen-Hsuan Hou, and Ken N. Kuo (2019) The relationship between health literacy and perceived shared decision making in patients with breast cancer. Patient education and counseling 102(2):360–366.

  8. Müller-Engelmann M, Donner-Banzhoff N, Keller H, Rosinger L, Sauer C, Rehfeldt K, Krones T (2013) When decisions should be shared: a study of social norms in medical decision making using a factorial survey approach. Med Decis Mak 33(1):37–47

    Article  Google Scholar 

  9. Ernstmann N, Neumann M, Ommen O, Galushko M, Wirtz M, Voltz R, Hallek M, Pfaff H (2009) Determinants and implications of cancer patients’ psychosocial needs. Support Care Cancer 17(11):1417–1423

    Article  CAS  PubMed  Google Scholar 

  10. Halbach SM, Enders A, Kowalski C, Pförtner TK, Pfaff H, Wesselmann S, Ernstmann N (2016) Health literacy and fear of cancer progression in elderly women newly diagnosed with breast cancer—a longitudinal analysis. Patient Educ Couns 99(5):855–862

    Article  PubMed  Google Scholar 

  11. Wallberg B, Michelson H, Nystedt M, Bolund C, Degner LF, Nils Wilking B (2000) Information needs and preferences for participation in treatment decisions among Swedish breast cancer patients. Acta Oncol 39(4):467–476

    Article  CAS  PubMed  Google Scholar 

  12. Kelley M et al (2015) Patient perspectives on the learning health system: The importance of trust and shared decision making. Am J Bioeth 15(9):4–17

    Article  PubMed  PubMed Central  Google Scholar 

  13. AM O'Connor. Ottawa decision support framework to address decisional conflict. 2006 [cited 2016 1/17/16]; Available from: https://decisionaid.ohri.ca/docs/develop/ODSF.pdf

    Google Scholar 

  14. Charmaz, Kathy (2014) Constructing grounded theory. Sage

  15. Shenton AK (2004) Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf 22(2):63–75

    Google Scholar 

  16. Hesse BW (2012) The patient, the physician, and Dr. Google. Virtual Mentor 14(5):398–402. https://doi.org/10.1001/journalofethics.2012.14.5.stas1-1205.

    Article  PubMed  Google Scholar 

  17. Leydon GM et al (2000) Cancer patients' information needs and information seeking behaviour: in depth interview study. BMJ 320(7239):909–913

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hobbs GS et al (2015) The role of families in decisions regarding cancer treatments. Cancer 121(7):1079–1087

    Article  PubMed  Google Scholar 

  19. Rheingold, Howard (2000) The virtual community: Homesteading on the electronic frontier. MIT press

  20. Dumitru RC, Ganslandt T, Prokosch H-U (2006) German healthcare consumer’s perception of the internet as a source of health related information. In: AMIA Annual Symposium Proceedings. American Medical Informatics Association

  21. Caiata-Zufferey M et al (2010) Online health information seeking in the context of the medical consultation in Switzerland. Qual Health Res 20(8):1050–1061

    Article  PubMed  Google Scholar 

  22. III CHB (2001) Through the Physician's eyes: the patients (internet)-physician relationship. Virtual Mentor 3(3):2001. https://doi.org/10.1001/virtualmentor.2001.3.3.prsp2-0103

    Article  Google Scholar 

  23. Tan AS (2015) A study of the frequency and social determinants of exposure to cancer-related direct-to-consumer advertising among breast, prostate, and colorectal cancer patients. Health Commun 30(11):1102–1111

    Article  PubMed  Google Scholar 

  24. Budden LM, Hayes BA, Buettner PG (2014) Women’s decision satisfaction and psychological distress following early breast cancer treatment: a treatment decision support role for nurses. Int J Nurs Pract 20(1):8–16

    Article  PubMed  Google Scholar 

  25. Davis TC et al (1993) Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med 25(6):391–395

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Alabama at Birmingham, 1720 2nd Avenue South, 540A, Birmingham, AL, 35294-1212, USA

    Soumya J. Niranjan, Audrey Wallace, Beverly R. Williams, Yasemin Turkman, Courtney P. Williams, Smita Bhatia & Gabrielle B. Rocque

  2. University of Utah, Salt Lake City, UT, 84112, USA

    Sara Knight

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  1. Soumya J. Niranjan
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  2. Audrey Wallace
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Correspondence to Soumya J. Niranjan.

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Niranjan, S.J., Wallace, A., Williams, B.R. et al. Trust but Verify: Exploring the Role of Treatment-Related Information and Patient-Physician Trust in Shared Decision Making Among Patients with Metastatic Breast Cancer. J Canc Educ 35, 885–892 (2020). https://doi.org/10.1007/s13187-019-01538-x

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