Understanding the Engagement of Key Decision Support Persons in Patient Decision Making Around Breast Cancer Treatment

Details

• Alternative Title:
  Cancer
• Personal Author:
  Veenstra, Christine M. ; Wallner, Lauren P. ; Abrahamse, Paul ; Janz, Nancy K. ; Katz, Steven J. ; Hawley, Sarah T.
• Description:
  Background:
  
  Breast cancer patients involve multiple decision support persons (DSPs) in treatment decision making, yet little is known about DSP engagement in decision making and association with patient appraisal of the decision process.
  
  Methods:
  
  Newly diagnosed breast cancer patients reported to Georgia and LA SEER registries in 2014–15 were surveyed 7 months after diagnosis. The individual most involved in the respondent’s decision making (key DSP) was surveyed. DSP engagement was measured across 3 domains: 1) Informed about decisions; 2) Involved in decisions; 3) Aware of patients’ preferences. Patient decision appraisal included subjective decision quality and deliberation. We evaluated bivariate associations using chi-square tests between domains of DSP engagement and DSP independent variables. We used Anova and multivariable logistic regression to compare domains of DSP engagement with patient decision appraisal.
  
  Results:
  
  2502 patients (68% RR) and 1203 eligible DSPs (70% RR) responded. Most DSPs were husbands/partners or daughters, white, and college graduates. Husbands/partners were more likely to be more informed, involved, and aware (all p<0.001). English- and Spanish-speaking Latinos had higher extent of (p 0.017), but lower satisfaction with involvement (p<0.001). A highly informed DSP was associated with higher odds of patient-reported subjective decision quality (OR 1.46; 95% CI 1.03–2.08, p=0.03). A highly aware DSP was associated with higher odds of patient-reported deliberation (OR 1.83; 95% CI 1.36–2.47, p<.001).
  
  Conclusions:
  
  In this population-based study, informal DSPs were engaged with and positively contributed to patients’ treatment decision making. To improve decision quality, future interventions should incorporate DSPs.
  
  
• Subjects:
  Adult Aged Age Factors Breast Neoplasms Cohort Studies Confidence Intervals Decision Making, Shared Decision Support Techniques Female Hispanic Or Latino Humans Logistic Models Middle Aged Odds Ratio Registries Risk Assessment Socioeconomic Factors Surveys And Questionnaires White People

  More +
• Source:
  Cancer. 125(10):1709-1716
• Pubmed ID:
  30633326
• Pubmed Central ID:
  PMC6486440
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; HHSN261201300015C/RC/CCR NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003862/DP/NCCDPHP CDC HHS/United States ; K07 CA196752/CA/NCI NIH HHS/United States ; P01 CA163233/CA/NCI NIH HHS/United States ; U58 DP003875/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  Georgia ; Los Angeles, CA
• Volume:
  125
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e300b38a15ef08d3fc9d217c6ff0760e41aa92ef7d68247b699ac23fae1801ee
• Download URL:
  https://stacks.cdc.gov/view/cdc/78268/cdc_78268_DS1.pdf
• File Type:
  [PDF - 165.62 KB ]