title: Treatment decision-making in the medical encounter: comparing the attitudes of French surgeons and their patients in breast cancer care.
abstract: OBJECTIVE
  To explore attitudes of French surgeons and their patients towards treatment decision-making (TDM) in the medical encounter.
  
  
  METHODS
  Surgeons involved in early stage breast cancer and their patients treated in a French cancer care network received a cross-sectional survey questionnaire containing examples of four different approaches to TDM: paternalistic, "some sharing", informed TDM and, shared TDM.
  
  
  RESULTS
  Surgeons' interaction styles were clearly distributed among paternalistic, shared and mixed. The paternalistic approach seemed to be associated with private rather than public practice and with less professional experience. Patients reported a rather low level of participation in TDM, varying by socio-demographic characteristics. One third of patients were dissatisfied with the way their treatment decision had been made.
  
  
  CONCLUSIONS
  Most surgeons reported adopting the "some sharing" approach. However, one patient out of three reported that they would have liked to participate more in the TDM process.
  
  
  CONCLUSIONS
  Surgeons need to ask patients what their preferences for involvement in TDM are and then think about ways to accommodate both their own and patients' preferences regarding the TDM process to be used in each encounter. In addition, decision aids could be offered to surgeons to help them discuss treatment options with their patients.
authors: Lyon University, F-69622 Lyon, France; Lyon 1 University, Villeurbanne, France; CNRS, UMR5824, Groupe d'Analyse et de Théorie Economique Lyon Saint-Etienne, France; Centre Léon Bérard, F-69008 Lyon, France.
authors: Florence
authors: F
authors: Nguyen
authors: Lyon University, F-69622 Lyon, France; Lyon 1 University, Villeurbanne, France; CNRS, UMR5824, Groupe d'Analyse et de Théorie Economique Lyon Saint-Etienne, France; Centre Léon Bérard, F-69008 Lyon, France. Electronic address: nora.moumjid@univ-lyon1.fr.
authors: Nora
authors: N
authors: Moumjid
authors: CHEPA (Center for Health Economics and Policy Analysis), Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors: Cathy
authors: C
authors: Charles
authors: CHEPA (Center for Health Economics and Policy Analysis), Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors: Amiram
authors: A
authors: Gafni
authors: Juravinski Cancer Centre, Hamilton, Ontario, Canada.
authors: Tim
authors: T
authors: Whelan
authors: Lyon University, F-69622 Lyon, France; Lyon 1 University, Villeurbanne, France; CNRS, UMR5824, Groupe d'Analyse et de Théorie Economique Lyon Saint-Etienne, France; Centre Léon Bérard, F-69008 Lyon, France.
authors: Marie-Odile
authors: MO
authors: Carrère
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000601:surgery*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D010358:Patient Participation; D057240:Patient Preference; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D066231:Surgeons / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Breast cancer; Medical encounter; Patient participation; Treatment decision-making