Status quo of advanced cancer patients participating in shared decision- making in China: A mixed study

Abstract

Abstract Purpose Patients with advanced cancer are usually willing to participate in shared decision-making (SDM), but in clinical practice, the participation of patients is easily ignored due to many factors. This study aimed to analyze the current status of SDM among patients with advanced cancer in China and the related factors affecting patient participation. Methods A cross-sectional survey was conducted on 513 advanced cancer patients in 16 tertiary hospitals of China. The general situation questionnaire, the Control Preference Scale (CPS) and Perceived-involvement in Care Scale (PICS) were used to analyze the current status of SDM and influencing factors. Based on the Ottawa Decision Support Framework (ODSF), 17 advanced cancer patients were interviewed to explore the perceptions of advanced cancer patients on SDM. Results There is a difference between actual situation and expectation of patients' participation in decision-making tendency, and the statistically significant influencing factors were age, payment, and whether worried about the therapeutic effect. We also found the dynamic change of decision-making mode, the acquisition of disease information, the obstacles of decision-making participation and the role of family members would effect the type of patients' SDM. Conclusion The SDM status of advanced cancer patients in China is dominated by sharing, and in a continuous dynamic change. Influenced by Chinese traditional culture, family members play an important role in shared decision-making.