Shared decision-making for cancer care among racial and ethnic minorities: a systematic review

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.

FIGURE 1—

Search and selection of published literature on shared decision-making, cancer, and minority groups through July 2011 in 4 electronic databases. Note. Multiple studies fit more than 1 exclusion criteria.

FIGURE 2—

A conceptual model of influences on cancer treatment decision-making among racial/ethnic minority patients.