Physicians' decision-making style and psychosocial outcomes among cancer survivors.
OBJECTIVE
We evaluated pathways linking physicians' decision-making style with cancer survivors' health-related quality of life (HRQOL).


METHODS
We analyzed survey data from 623 survivors diagnosed with leukemia, colorectal, or bladder cancer in Northern California, 2-5 years prior to the study. Of these, 395 reported making a medical decision in the past 12 months and were asked about their physician's decision-making style. We evaluated the association of physician style with proximal communication outcomes (trust and participation self-efficacy), intermediate cognitive outcomes (perceived control and uncertainty), and distal health outcomes (physical and mental HRQOL).


RESULTS
Overall, 54% of survivors reported a sub-optimal decision-making style for their physician. With the exception of physical health, physician style was associated with all proximal, intermediate, and distal outcomes (p< or =0.01). We identified two significant pathways by which a participatory physician style may be associated with survivors' mental health: (1) by increasing survivors' participation self-efficacy and thereby enhancing their perceptions of personal control (p<0.01); (2) by enhancing survivors' level of trust and thereby reducing their perceptions of uncertainty (p<0.05).


CONCLUSIONS
A participatory physician style may improve survivors' mental health by a complex two-step mechanism of improving survivors' proximal communication and intermediate cognitive outcomes.


CONCLUSIONS
Physicians who adopt a participatory decision-making style are likely to facilitate patient empowerment and enhance patients' HRQOL.
Arora
Neeraj K
NK
Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Blvd, MSC 7344, EPN 4092, Bethesda, MD 20892-7344, USA. aroran@mail.nih.gov
Weaver
Kathryn E
KE
Clayman
Marla L
ML
Oakley-Girvan
Ingrid
I
Potosky
Arnold L
AL
D000223:Adaptation, Psychological; D015179:Colorectal Neoplasms; D003657:Decision Making; D005260:Female; D006801:Humans; D007938:Leukemia; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010817:Physician-Patient Relations; D010820:Physicians; D011594:Psychometrics; D011788:Quality of Life; D013315:Stress, Psychological; D001749:Urinary Bladder Neoplasms