Objective To investigate the attitudes of Chinese doctors towards the difficulties they have concerning the involvement of patients in decision-making about treatment. Method We surveyed 1 088 doctors at different levels (70% internal medicine, 22% general surgery, 8% gynecology) from 20 general hospitals and 5 university hospitals covering 25 provinces and cities in China, using a simple questionnaire, which we had developed. Results A total of 780 doctors returned the questionnaire and of these only 488 (62%) had completed it. The difficulties that doctors were most concerned about focused on lack of time (27%), expressing uncertainties to patients (15%), dealing with patients who have little medical knowledge (13%), eliciting patients’ preferences (12%), and establishing a stable relationship (9%). Conclusion Increasing their knowledge of patient involvement in making treatment decisions may reinforce appropriate attitudes towards this concept among doctors.
ObjectiveTo systematically review the influencing factors of breast cancer patients in treatment decision-making. MethodsWeb of Science, PubMed, EMbase, The Cochrane Library, JBI Evidence Synthesis, CINAHL, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect qualitative studies about the influencing factors of breast cancer patients in treatment decision-making from inception to October 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then, the results were combined using integrating methods. ResultsA total of 13 studies were included. Sixty-seven results were extracted, with 22 results retained after incorporation and removal of duplications. The 22 results were grouped according to their similarities to form 6 categories. These categories resulted in two synthesized findings: influencing factors of patient participation in treatment decision-making and integration results and influencing factors of patients' treatment options. ConclusionBreast cancer patient participation in treatment decisions is influenced not only by internal factors, but also by family and external situational factors. When patients choose treatment, they consider not only their personal values and preferences, but also the impact of treatment on their families and their expectations. The choice is also influenced by social and cultural aspects.
ObjectiveTo overview the systematic reviews of the efficacy of cancer patient decision aids (PDAs) for treatment decision-making. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CINAHL, JBI, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect the systematic reviews relevant to the objective from inception to September 2023. Literature screening, data extraction, methodological quality assessment of the included literature, and summary and grading of the evidence were carried out independently by two researchers, and duplication of original studies in the included systematic evaluations was investigated using the corrected covered area (CCA). ResultsA total of 17 systematic reviews were included, of which 13 (76.47%) were low- or very low-quality studies. A total of 64 pieces of evidence were included, of which only 26 (40.62%) were of moderate quality, and the original studies included in the included literature had a low degree of overlap (CCA=0.05). The results of meta-analysis showed that PDAs could increase decision-related knowledge, reduce decision conflict and regret in cancer patients' treatment decision (P<0.05). However, there was no significant difference in decision satisfaction, anxiety or depression (P>0.05). ConclusionPDAs can improve cancer patients' knowledge related to treatment decision, reduce decision conflicts and regrets, and have no significant negative effects on decision preparation, satisfaction, anxiety, and depression. However, the existing systematic reviews are of low quality and limited to a few cancer types.