title: Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.
abstract: The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available.
authors.affiliation: Groupe de Recherche en Psychologie Sociale, Institut de psychologie (GRePS), Université de Lyon (Lyon 2), Bron, France.|CIC-EC3, Inserm, Preducan, Institut de Cancérologie de la Loire, St-Priest-en-Jarez, France.
authors.forename: C
authors.initials: C
authors.lastname: Durif-Bruckert
authors.affiliation: Groupe de Recherche en Psychologie Sociale, Institut de psychologie (GRePS), Université de Lyon (Lyon 2), Bron, France.
authors.forename: P
authors.initials: P
authors.lastname: Roux
authors.affiliation: Centre Léon Bérard, Lyon, France.|GATE Lyon St Etienne CNRS UMR 5824, Ecully, France.
authors.forename: M
authors.initials: M
authors.lastname: Morelle
authors.affiliation: Centre Léon Bérard, Lyon, France.
authors.forename: H
authors.initials: H
authors.lastname: Mignotte
authors.affiliation: Centre Léon Bérard, Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Faure
authors.affiliation: Centre Léon Bérard, Lyon, France.|GATE Lyon St Etienne CNRS UMR 5824, Ecully, France.|Université Lyon 1, Villeurbanne, France.
authors.forename: N
authors.initials: N
authors.lastname: Moumjid-Ferdjaoui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001362:Avoidance Learning; D001943:Breast Neoplasms / Q000601:surgery*; D002173:Cancer Care Facilities; D032882:Comprehension; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012941:Social Responsibility
keywords: breast cancer; decision-making; information; participation; triangulation; users' experiences