The Encounter of Two Worlds: Divided Narratives of Decision‐Making on Cancer Treatment Between Physicians and Patients.

Introduction: Divided narratives pose long‐standing difficulties in physician and patient communication. In decision‐making on cancer treatment, divided narratives between physicians and patients hinder mutual understanding and agreement over the illness and its treatment. For effective decision‐mak...

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Publicado en:Health Expectations Vol. 27; no. 5; pp. 1 - 11
Autores principales: Lu, Weiwei, Wong, Dennis Sing Wing
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2024
Acceso en línea:Ver este registro en EBSCOhost
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        atl: The Encounter of Two Worlds: Divided Narratives of Decision‐Making on Cancer Treatment Between Physicians and Patients.
      aug:
        au:
          Lu, Weiwei
          Wong, Dennis Sing Wing
        affil: Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
      sug:
        subj:
          Narratives Evaluation
          Decision Making, Shared Psychosocial Factors
          Attitude to Medical Treatment
          Physician Attitudes
          Patient Attitudes
          Oncologic Care
          Neoplasms Therapy
          Human
          Qualitative Studies
          Cancer Patients
          China
          Grounded Theory
          Goal-Setting
          Trust
          Communication Barriers
          Financial Stress
          Family Relations
          Patient Centered Care
          Attitude to Illness
          Interviews
          Female
          Male
          Female
          Male
      ab: Introduction: Divided narratives pose long‐standing difficulties in physician and patient communication. In decision‐making on cancer treatment, divided narratives between physicians and patients hinder mutual understanding and agreement over the illness and its treatment. For effective decision‐making on treatments, it is necessary to investigate the similarities and differences in these divided narratives. Methods: This study adopted a qualitative research design of narrative inquiry to examine the data, which included interviews with 32 cancer patients and 16 paired physicians in two hospitals in China. Data analysis was conducted using grounded theory to generate findings. Results: Both physicians and patients were concerned about goals and obstacles to their decision‐making on cancer treatment. Four common aspects of goal setting were identified from the divided narratives: decision pools, treatment goals, identity practice and preferred identity. Four common obstacles were identified: pains and trust, communication gap, financial issues and complex family. However, the meanings attached to these eight aspects differed between physicians and patients. Conclusion: Cancer treatment decision‐making is an encounter of the scientific world and lifeworld. A divided narrative approach can identify the similarities and differences in the decision‐making on cancer treatment between physicians and patients. Physicians generally adopt a rational decision‐making approach, whereas patients generally adopt a relational decision‐making approach. Despite the common concerns in their goals and obstacles, physicians and patients differed in their contextualized interpretations, which demonstrates the physicians' and the patients' pursuit of preferred identities in decision‐making. The results of this study provide a new perspective to treatment decision‐making, emphasizing the importance of narrative integration in reaching mutual agreement. Patient and Public Contribution: The findings were shared with 15 cancer patients and caregivers for feedback and advice in June 2024. This study was also presented at the international conferences of COMET (International and Interdisciplinary Conference on Communication, Medicine, and Ethics) and ICCH (International Conference on Communication in Healthcare) 2023 for continuous feedback and comments.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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