title: Does the use of shared decision-making consultation behaviors increase treatment decision-making satisfaction among Chinese women facing decision for breast cancer surgery?
abstract: OBJECTIVE
  To assess the extent to which breast surgical consultations used shared decision making (SDM), identify factors associated with use of SDM, and assess if using SDM increases decision-making satisfaction.
  
  
  METHODS
  Two hundred and eighty-three video-recorded diagnostic-treatment decision consultations between breast surgeons and women with breast cancer were assessed using the Decision Analysis System for Oncology (DAS-O) coding system designed for assessing SDM behaviors. Women completed a questionnaire at pre-consultation, one-week post-consultation and one-month post-surgery. Patient outcomes included decision conflict, patient satisfaction with medical consultation, and decision regret.
  
  
  RESULTS
  Overall, the level of SDM behaviors was low. The extent of SDM behavior within consultation was related to greater consultation duration (p<0.001), more than one treatment being offered (p<0.001), and fewer questions raised by patients/companions (p<0.05). While use of SDM consultation did not influence post-consultation decision conflict, it increased satisfaction with information given and explained, patients' feelings of trust and confidence in their surgeons, and reduced post-surgical decision regret.
  
  
  CONCLUSIONS
  These breast surgical consultations mostly adopted informed treatment decision-making approaches. Using SDM improved patient consultation and decision satisfaction.
  
  
  CONCLUSIONS
  The study findings highlight a need to reinforce the importance of SDM in consultations among breast surgeons.
authors: School of Public Health, The University of Hong Kong, Hong Kong. Electronic address: wwtlam@hku.hk.
authors: Wendy W T
authors: WW
authors: Lam
authors: School of Public Health, The University of Hong Kong, Hong Kong.
authors: Marie
authors: M
authors: Kwok
authors: The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong.
authors: Miranda
authors: M
authors: Chan
authors: The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong.
authors: Wai Ka
authors: WK
authors: Hung
authors: The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong.
authors: Marcus
authors: M
authors: Ying
authors: The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong.
authors: Amy
authors: A
authors: Or
authors: Breast Surgery Division, Department of Surgery, The University of Hong Kong, Hong Kong.
authors: Ava
authors: A
authors: Kwong
authors: Breast Surgery Division, Department of Surgery, The University of Hong Kong, Hong Kong.
authors: Dacita
authors: D
authors: Suen
authors: School of Public Health, The University of Hong Kong, Hong Kong.
authors: Sungwon
authors: S
authors: Yoon
authors: School of Public Health, The University of Hong Kong, Hong Kong.
authors: Richard
authors: R
authors: Fielding
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology*; D001943:Breast Neoplasms / Q000208:ethnology / Q000523:psychology* / Q000601:surgery; D002681:China; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010358:Patient Participation; D017060:Patient Satisfaction / Q000208:ethnology*; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013637:Tape Recording
keywords: Breast cancer; Breast surgical consultation; Chinese; Shared decision making