"It Depends on the Situation": Variability in How Surgical Oncologists Elicit and Integrate Patient Values.

Area of Science:

• Oncology
• Surgical Oncology
• Health Services Research

Background:

• Patient-centered care requires understanding patient values, especially in surgical oncology where tradeoffs are common.
• This study investigates how surgeons handle patient values in cancer treatment decision-making.

Purpose of the Study:

• To explore how surgical oncologists elicit, integrate, document, and support patient values in cancer-related decision-making.
• To identify barriers and facilitators in incorporating patient values into surgical oncology care.

Main Methods:

• Qualitative descriptive study using semi-structured interviews with 14 surgical oncologists.
• Participants were purposively sampled for demographic variation.
• Thematic analysis was used to analyze interview transcripts.

Main Results:

• Surgeons used varied, often situational, methods to elicit patient values, including inferring from context and discussing survival vs. quality-of-life tradeoffs.
• Values elicitation occurred mainly in high-risk or preference-sensitive scenarios.
• Documentation practices varied, influenced by relevance, medicolegal concerns, and workflow.

Conclusions:

• Patient values elicitation in surgical oncology is inconsistent and situational, not routine.
• Implementing more structured, earlier value-based discussions and providing system-level support can improve alignment of surgical decisions with patient values.