title: How Does a Shared Decision-Making (SDM) Intervention for Oncologists Affect Participation Style and Preference Matching in Patients with Breast and Colon Cancer?
abstract: The aims of this study are to assess patients' preferred and perceived decision-making roles and preference matching in a sample of German breast and colon cancer patients and to investigate how a shared decision-making (SDM) intervention for oncologists influences patients' preferred and perceived decision-making roles and the attainment of preference matches. This study is a post hoc analysis of a randomised controlled trial (RCT) on the effects of an SDM intervention. The SDM intervention was a 12-h SDM training program for physicians in combination with decision board use. For this study, we analysed a subgroup of 107 breast and colon cancer patients faced with serious treatment decisions who provided data on specific questionnaires with regard to their preferred and perceived decision-making roles (passive, SDM or active). Patients filled in questionnaires immediately following a decision-relevant consultation (t1) with their oncologist. Eleven of these patients' 27 treating oncologists had received the SDM intervention within the RCT. A majority of cancer patients (60%) preferred SDM. A match between preferred and perceived decision-making roles was reached for 72% of patients. The patients treated by SDM-trained physicians perceived greater autonomy in their decision making (p < 0.05) with more patients perceiving SDM or an active role, but their preference matching was not influenced. A SDM intervention for oncologists boosted patient autonomy but did not improve preference matching. This highlights the already well-known reluctance of physicians to engage in explicit role clarification.
  
  
  
  German Clinical Trials Register DRKS00000539; Funding Source: German Cancer Aid.
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115, Heidelberg, Germany. Christiane.Bieber@med.uni-heidelberg.de.
authors.forename: Christiane
authors.identifier: 0000-0001-8047-4174
authors.initials: C
authors.lastname: Bieber
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115, Heidelberg, Germany.|Department of Psychology III - Cognition and Individual Differences, University of Mannheim, Mannheim, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nicolai
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115, Heidelberg, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Gschwendtner
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115, Heidelberg, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Müller
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Reuter
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Buchholz
authors.affiliation: Practice for Gastroenterology and Oncology, Schwetzingen, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Kallinowski
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115, Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Eich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D002755:Choice Behavior; D003110:Colonic Neoplasms / Q000523:psychology / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072103:Oncologists / Q000523:psychology / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Breast and colon cancer; Oncology; Physician training program; Preference matching; Shared decision making (SDM)