Patient Preferences and Satisfaction With Decisions in Stage-III Melanoma: A Mixed Methods Study.

Autor: Mott NM; University of Michigan Medical School, Ann Arbor, Michigan; University of Michigan, Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan; University of Colorado Anschutz Medical Campus, Department of Surgery, Aurora, Colorado., Bredbeck BC; University of Michigan, Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan; University of Michigan, Department of Surgery, Ann Arbor, Michigan., Kazemi RJ; University of Michigan Medical School, Ann Arbor, Michigan., Ellsworth BL; University of Michigan Medical School, Ann Arbor, Michigan; University of Michigan, Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan., Hughes TM; University of Michigan, Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan; University of Michigan, Department of Surgery, Ann Arbor, Michigan., Angeles CV; University of Michigan, Department of Surgery, Ann Arbor, Michigan; University of Michigan, Department of Dermatology, Ann Arbor, Michigan., Dossett LA; University of Michigan, Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan; University of Michigan, Department of Surgery, Ann Arbor, Michigan. Electronic address: ldossett@umich.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2023 Mar; Vol. 283, pp. 485-493. Date of Electronic Publication: 2022 Nov 24.
DOI: 10.1016/j.jss.2022.10.079
Abstrakt: Introduction: Rapid accumulation of data in surgical and medical oncology has changed the treatment landscape for patients with stage-III melanoma, introducing options for active surveillance and adjuvant systemic therapy; however, these options have increased the complexity of decision making.
Methods: We conducted an explanatory sequential mixed-methods study consisting of surveys and semistructured interviews among patients diagnosed with stage-III melanoma at a single institution from August 2019 to December 2021. The survey included the validated 30-point satisfaction with decision scale (SWD). The interview guide was developed using a shared decision-making framework.
Results: Twenty-six participants completed the survey (response rate 40%) and 17 were interviewed. In the survey, 69% of participants reported receiving a recommendation for active surveillance and 23% received a recommendation for adjuvant systemic therapy. Overall SWD for treatment of the lymph node basin and adjuvant systemic therapy was high at 27.94 and 26.21 out of 30, respectively. In the interviews, participants stressed the importance of the physician's recommendation as well as the desire to minimize intervention and avoid potential side effects in their decisions. However, they demonstrated persistent knowledge gaps in their understanding of the treatment options.
Conclusions: Like other cancer types where the option for active surveillance exists, the physician's recommendation is influential in shaping decisions for patients with stage-III melanoma. Physicians can improve shared decision making in this complex treatment landscape through improved multidisciplinary collaboration and mechanisms for ensuring patients' understanding of the treatment options.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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