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. 2023 Feb 11:16:397-409.
doi: 10.2147/JMDH.S397300. eCollection 2023.

Shared-Decision-Making Experiences in Breast Cancer Care with and without Patient Participation in Multidisciplinary Tumor Conferences: A Mixed-Methods-Study

Christian Heuser  1   2 , Barbara Schellenberger  1   2 , Nicole Ernstmann  1   2 , Annika Diekmann  1 , Emily Krüger  1 , Leonie Schreiber  1 , Isabelle Scholl  3 , Lena Ansmann  4
Affiliations

Shared-Decision-Making Experiences in Breast Cancer Care with and without Patient Participation in Multidisciplinary Tumor Conferences: A Mixed-Methods-Study

Christian Heuser et al. J Multidiscip Healthc. .

Abstract

Purpose: This study aimed (1) to analyze patients' perceived shared decision-making (SDM) experiences over 4 weeks between patients participating or not in multidisciplinary tumor conferences (MTCs) and (2) to analyze the association of patients' active participation in and organizational variables of MTCs with patients' perceived SDM experience directly after MTC.

Patients and methods: From the N=317 patients, this observational study included patient surveys, observations, and audio transcripts from MTCs with (N=82) and without (N=145) patient participation in six breast and gynecologic cancer centers. We performed t tests for within- and between-group comparisons and linear regression with "patients' perceived SDM experiences in MTC" as the dependent variable.

Results: Patients' perceived SDM experiences increased at 4 weeks after MTC (p<0.001) with lower perceived SDM experiences for participating versus nonparticipating patients (p<0.001). Linear regression showed that the organizational variable "round table seating arrangement" was significantly associated with higher perceived SDM experiences compared with a theater or U-shape arrangement (beta=-0.38, p=0.043; beta=-0.69, p=0.010) directly after MTC.

Conclusion: Results provide first insights into patients' perceived SDM experiences in MTCs. SDM in MTCs is associated with organizational variables of MTCs. A round table seating arrangement in MTCs with patient participation seems important for patients' perceived SDM experiences. The relatively low perceived SDM experiences of participating patients directly after MTC indicates room for improvement, eg concerning patient-centered communication.

Keywords: multidisciplinary healthcare; multidisciplinary team meetings; multidisciplinary tumor conference; oncology; patient-centered communication; shared decision making.

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Conflict of interest statement

IS has been members of the executive board of the International Shared Decision Making Society, which has a mission to foster SDM implementation. LA declares grants from German Cancer Aid, during the conduct of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Variables and measures used.
Figure 2
Figure 2
Flow diagram of participants.
See this image and copyright information in PMC

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