title: Decisional control preferences, disclosure of information preferences, and satisfaction among Hispanic patients with advanced cancer.
abstract: BACKGROUND
  Studies to determine the decisional control preferences (DCPs) in Hispanic patients receiving palliative care are limited.
  
  
  OBJECTIVE
  The aims of this study were to describe DCPs, disclosure of information, and satisfaction with decision making among Hispanics and to determine the degree of concordance between patients' DCPs and their self-reported decisions.
  
  
  METHODS
  We surveyed 387 cancer patients referred to outpatient palliative care clinics in Argentina, Chile, Guatemala, and the U.S. DCPs were measured with the Control Preference Scale, disclosure preferences with the Disclosure of Information Preferences questionnaire, and satisfaction with care with the Satisfaction with Decision Scale.
  
  
  RESULTS
  In this study, 182 patients (47.6%) preferred shared decisional control, 119 (31.2%) preferred active decisional control, and 81 (21.2%) preferred a passive approach. Concerning their diagnosis and prognosis, 345 (92%) patients wanted to know their diagnosis, and 355 (94%) wanted to know their prognosis. Three hundred thirty-seven (87%) patients were satisfied with the decision-making process. DCPs were concordant with the self-reported decision-making process in 264 (69%) patients (weighted kappa = 0.55). Patients' greater satisfaction with the decision-making process was correlated with older age (P ≤ 0.001) and with a preference for enhanced diagnostic disclosure (P ≤ 0.024). Satisfaction did not correlate with concordance in the decision-making process.
  
  
  CONCLUSIONS
  The vast majority preferred a shared or active decision-making process and wanted information about their diagnosis and prognosis. Older patients and those who wanted to know their diagnosis seemed to be more satisfied with the way treatment decisions were made.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Hospital Centro de Cuidados Laguna, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Noguera
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Sriram
authors.initials: S
authors.lastname: Yennurajalingam
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Dorothy I. Height Center for Health Equity & Evaluation Research, University of Houston Graduate College of Social Work, Houston, Texas, USA.
authors.forename: Isabel
authors.initials: I
authors.lastname: Torres-Vigil
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Henrique Afonseca
authors.initials: HA
authors.lastname: Parsons
authors.affiliation: Instituto de Cancerologia, Guatemala City, Guatemala.
authors.forename: Eva Rosina
authors.initials: ER
authors.lastname: Duarte
authors.affiliation: Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Palma
authors.affiliation: Palliative Care Unit, Hospital Tornu, Programa Argentino de Medicina Paliativa-Fundación FEMEBA, Buenos Aires, Argentina.
authors.forename: Sofia
authors.initials: S
authors.lastname: Bunge
authors.affiliation: Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. Electronic address: ebruera@mdanderson.org.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D002677:Chile; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006166:Guatemala; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000523:psychology* / Q000706:statistics & numerical data; D010358:Patient Participation / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000208:ethnology* / Q000706:statistics & numerical data; D057566:Self Report; D014481:United States; D055815:Young Adult
keywords: Palliative care; advanced cancer; decisional control preferences; disclosure of information preferences
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