title: Considering patient values and treatment preferences enhances patient involvement in rectal cancer treatment decision making.
abstract: BACKGROUND
  The shared decision making (SDM) model states that patients' values and preferences should be clarified to choose a strategy that best fits the patient. This study aimed to assess whether values and preferences of rectal cancer patients are voiced and considered in deciding about preoperative radiotherapy (PRT), and whether this makes patients feel more involved in treatment decision making.
  
  
  METHODS
  Pre-treatment consultations of radiation oncologists and patients eligible for PRT were audiotaped (N=90). Tapes were transcribed and coded to identify patients' values and treatment preferences. Patients filled in a post-consultation questionnaire on their perceived involvement in decision making (N=60).
  
  
  RESULTS
  Patients' values were voiced for 62/611 of benefits/harms addressed (10%), in 38/90 consultations (42%; maximum 4 values per consultation), and most often related to major long-term treatment outcomes. Patients' treatment preferences were discussed in 20/90 consultations (22%). In 16/90 consultations (18%), the oncologists explicitly indicated to consider patients' values or preferences. Patients perceived a significantly more active role in decision making if their values or preferences had been voiced or considered.
  
  
  CONCLUSIONS
  Patients' values and treatment preferences are voiced or considered in a minority of consultations. If they are, this increases patients' perceived involvement in the decision making process.
authors.affiliation: Leiden University Medical Center, Department of Medical Decision Making, The Netherlands.
authors.forename: Marleen
authors.initials: M
authors.lastname: Kunneman
authors.affiliation: Leiden University Medical Center, Department of Radiotherapy, The Netherlands.
authors.forename: Corrie A M
authors.initials: CA
authors.lastname: Marijnen
authors.affiliation: Leiden University Medical Center, Department of Medical Decision Making, The Netherlands.
authors.forename: Monique C M
authors.initials: MC
authors.lastname: Baas-Thijssen
authors.affiliation: Leiden University Medical Center, Department of Radiotherapy, The Netherlands.
authors.forename: Yvette M
authors.initials: YM
authors.lastname: van der Linden
authors.affiliation: Verbeeten Institute, Tilburg, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Rozema
authors.affiliation: Radiotherapy Group Deventer, The Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: Muller
authors.affiliation: Amsterdam Medical Center, Department of Radiation Oncology, The Netherlands.
authors.forename: Elisabeth D
authors.initials: ED
authors.lastname: Geijsen
authors.affiliation: Leiden University Medical Center, Department of Medical Decision Making, The Netherlands.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stiggelbout
authors.affiliation: Leiden University Medical Center, Department of Medical Decision Making, The Netherlands. Electronic address: Pieterse@lumc.nl.
authors.forename: Arwen H
authors.initials: AH
authors.lastname: Pieterse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010358:Patient Participation / Q000379:methods* / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000379:methods*; D012004:Rectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Communication; Patient values; Preoperative radiotherapy; Rectal cancer; Shared decision making; Treatment preferences