When life gives you no choice: Context of decision‐making when offered an oncology clinical trial.
Background: Patients with advanced cancer are faced with a wide variety of challenges and difficult treatment decisions made while in a vulnerable life‐threatening situation, including decisions about clinical trial participation. Internationally, there is a great focus on shared decision‐making as...
| Published in: | Scandinavian Journal of Caring Sciences Vol. 36; no. 1; pp. 81 - 90 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
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Wiley-Blackwell
Mar2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155146958&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155146958 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02839318 BD4 jtl: Scandinavian Journal of Caring Sciences issn: 02839318 maglogo: Y pubinfo: dt: Mar2022 vid: 36 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 155146958 155146958 155146958 10.1111/scs.12965 155146958 ppf: 81 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: When life gives you no choice: Context of decision‐making when offered an oncology clinical trial. aug: au: Gregersen, Trine A. Birkelund, Regner Wolderslund, Maiken Steffensen, Karina Dahl Ammentorp, Jette affil: Department of Oncology, Lillebaelt Hospital ‐ University Hospital of Southern Denmark, Vejle, Denmark sug: subj: Decision Making Evaluation Consumer Participation Research Subject Recruitment Clinical Trials Patients Health Personnel Professional Role Human Participant Observation Thematic Analysis Attitude to Medical Treatment Patient Attitudes Cues Attitude of Health Personnel Qualitative Studies Interviews Male Female Adult Middle Age Aged Data Analysis Software Field Notes Physician-Patient Relations Quality of Life Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Patients with advanced cancer are faced with a wide variety of challenges and difficult treatment decisions made while in a vulnerable life‐threatening situation, including decisions about clinical trial participation. Internationally, there is a great focus on shared decision‐making as a way to help patients and healthcare professionals to make informed decisions together; nevertheless, research focusing on patient experiences shows that information about clinical trials is insufficient in supporting patients to make trial decisions in the context of their course of disease and managing life with advanced cancer. Aim: To explore where and how decisions about participation in oncology clinical trials are made and the role of the patients and healthcare professionals. Methods: Participant observation was used as a qualitative research method to gain knowledge about decision‐making in different clinical situations. Data were analysed using thematic analysis. Results: Four themes were developed: (a) preformed decisions, (b) dissimilar perceptions of successful treatment, (c) cues and concerns stated by patients and (d) creating common ground. Conclusion: There are underexposed aspects to be aware of in the decision‐making process for clinical trial participation. Preformed decisions made by the physicians before the encounter with patients seemed to narrow down the patients' options and could have benefited from including the patients' views. Cues and concerns stated by patients were often neglected. However, when physicians talked with the patients about truly difficult issues such as treatment expectations, hope and death, it led to another kind of conversation about treatment decisions involving the patients' preferences. Implications for practice: Awareness of preformed decisions and an increased focus on picking up cues and concerns about existential issues in the clinical encounter may improve the quality of the decisions and increase shared decision‐making. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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