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Shared decision-making experiences regarding urinary diversion among Chinese patients with muscle-invasive bladder
Keping Zhu1, Ying Zhang1,2,3, Yusen Wang4
1Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Objective:
To explore the shared decision-making experiences and needs of Chinese patients with muscle-invasive bladder cancer considering urinary diversion.
Methods:
A phenomenological qualitative study was conducted at a tertiary hospital in Zhejiang Province, China. Eighteen participants were purposively recruited and completed 22 face-to-face semistructured interviews between May and September 2024. Data were analyzed using Colaizzi's seven-step method.
Results:
Four themes were identified: (1) patterns of involvement ranging from active participation to delegated decision-making; (2) reflections on imperfect treatment options; (3) priorities shaped by the tension between survival and quality of life; and (4) unmet information needs. Involvement and preferences were influenced by participants' knowledge, health status, occupation, family relationships, and other people's treatment experiences. Limited consultation time and difficulty understanding medical information constrained participation.
Conclusions:
Decisions about urinary diversion were individualized and embedded in clinical, family, and sociocultural contexts. Nurses and other healthcare professionals should provide staged, plain-language information, assess each patient's preferred level of involvement, include family members according to the patient's wishes, and support clarification of values and priorities throughout the perioperative period.