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Shared decision-making for cancer care among racial and ethnic minorities: a systematic review
Erin L Mead1, Ardith Z Doorenbos, Sara H Javid
1Erin L. Mead is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Ardith Z. Doorenbos is with the Department of Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle. Sara H. Javid and David R. Flum are with the Department of Surgery, University of Washington School of Medicine, Seattle. Emily A. Haozous is with the University of New Mexico College of Nursing, Albuquerque. Lori Arviso Alvord is with the University of Arizona College of Medicine, Tucson. Arden M. Morris is with the Center for Health Outcomes and Policy, Department of Surgery, University of Michigan Medical School, Ann Arbor.
Abstract:
To assess decision-making for cancer treatment among racial/ethnic minority patients, we systematically reviewed and synthesized evidence from studies of "shared decision-making," "cancer," and "minority groups," using PubMed, PsycInfo, CINAHL, and EMBASE. We identified significant themes that we compared across studies, refined, and organized into a conceptual model. Five major themes emerged: treatment decision-making, patient factors, family and important others, community, and provider factors. Thematic data overlapped categories, indicating that individuals' preferences for medical decision-making cannot be authentically examined outside the context of family and community. The shared decision-making model should be expanded beyond the traditional patient-physician dyad to include other important stakeholders in the cancer treatment decision process, such as family or community leaders.
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