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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 17, 2011
Communication-related aspects drive senior patients' satisfaction with the process of decision-making in cancer
Andreas Heidenreich1, Rabea Fuchshofen2, Susanne Elsner2
1Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23560, Luebeck, Germany. andreas.heidenreich@uksh.de.
Abstract:
Treatment decisions in cancer care can be life-critical and significantly affect self-determination concerns. Therefore, it is of great importance that the decision-making process is set up in the interest and satisfaction of the cancer patient. In a survey of 2,011 patients aged ≥ 50 years with breast cancer or colorectal cancer, 72.1% reported high satisfaction with the treatment decision-making process. Multivariate logistic regression identified several independent predictors of higher satisfaction: receiving comprehensive information about the illness and therapy options (adjusted odds ratio (aOR) 5.37, 95% CI 3.89-8.52), strong personal involvement in decision-making (aOR 2.93, 95% CI 2.15-3.98), perceived concordance among treating physicians (aOR 2.01, 95% CI 1.49-2.71), higher self-efficacy (aOR 1.63, 95% CI 1.31-2.04), and greater social support (aOR 1.36, 95% CI 1.10-1.67). Conversely, frailty was associated with lower satisfaction (aOR 0.66, 95% CI 0.48-0.90). These findings suggest that patient satisfaction with decision-making may be enhanced when physicians provide thorough information, actively involve patients in decisions, and coordinate care consistently, while frail patients and those with low self-efficacy or limited social networks may benefit from targeted support.
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