Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
Abstract Background Shared decision‐making has been shown to improve the quality of life in metastatic breast cancer patients in high‐literacy and high‐resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision‐making...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Health Expectations |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/hex.13590 |
| _version_ | 1798016215293100032 |
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| author | Ping Yein Lee Ai Theng Cheong Sazlina Shariff Ghazali Aneesa Abdul Rashid Siu Ching Ong Soo Ying Ong Adlinda Alip McCarthy Sylvia May Feng Chen Nur Aishah Taib Maheswari Jaganathan Chirk Jenn Ng Soo‐Hwang Teo |
| author_facet | Ping Yein Lee Ai Theng Cheong Sazlina Shariff Ghazali Aneesa Abdul Rashid Siu Ching Ong Soo Ying Ong Adlinda Alip McCarthy Sylvia May Feng Chen Nur Aishah Taib Maheswari Jaganathan Chirk Jenn Ng Soo‐Hwang Teo |
| author_sort | Ping Yein Lee |
| collection | DOAJ |
| description | Abstract Background Shared decision‐making has been shown to improve the quality of life in metastatic breast cancer patients in high‐literacy and high‐resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision‐making implementation and the barriers encountered in an Asian setting where societal norms predominate and physician decision‐making is at the forefront. This paper aims to identify (1) barriers to practising shared decision‐making faced by healthcare professionals and patients and (2) strategies for implementing shared decision‐making in the context of metastatic breast cancer management in Malaysia. Methods We conducted a qualitative study involving 12 patients diagnosed with metastatic breast cancer, 16 healthcare professionals and 5 policymakers from surgical and oncology departments at public healthcare centres in Malaysia. Semi‐structured in‐depth interviews and focus group discussions were conducted. The interviews were recorded, transcribed verbatim and analysed using the thematic approach. Nvivo software was used to manage and analyse the data. Results Five main themes emerged from the study: healthcare provider–patient communication, workforce availability, cultural and belief systems, goals of care and paternalism versus autonomy. Other strategies proposed to overcome barriers to implementing shared decision‐making were training of healthcare professionals and empowering nurses to manage patients' psychosocial issues. Conclusion This study found that practising shared decision‐making in the public health sector remains challenging when managing patients with metastatic breast cancer. The utilization of decision‐making tools, patient empowerment and healthcare provider training may help address the system and healthcare provider–patient barriers identified in this study. Patient or Public Contribution Patients were involved in the study design, recruitment and analysis. |
| first_indexed | 2024-04-11T15:45:53Z |
| format | Article |
| id | doaj.art-a2c3a2b5d32346bca922313d18af976f |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-04-11T15:45:53Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-a2c3a2b5d32346bca922313d18af976f2022-12-22T04:15:31ZengWileyHealth Expectations1369-65131369-76252022-12-012562837285010.1111/hex.13590Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian countryPing Yein Lee0Ai Theng Cheong1Sazlina Shariff Ghazali2Aneesa Abdul Rashid3Siu Ching Ong4Soo Ying Ong5Adlinda Alip6McCarthy Sylvia7May Feng Chen8Nur Aishah Taib9Maheswari Jaganathan10Chirk Jenn Ng11Soo‐Hwang Teo12UMeHealth Unit, Faculty of Medicine University of Malaya (UM) Kuala Lumpur MalaysiaDepartment of Family Medicine, Faculty of Medicine and Health Sciences Universiti Putra Malaysia (UPM) Kuala Lumpur MalaysiaDepartment of Family Medicine, Faculty of Medicine and Health Sciences Universiti Putra Malaysia (UPM) Kuala Lumpur MalaysiaDepartment of Family Medicine, Faculty of Medicine and Health Sciences Universiti Putra Malaysia (UPM) Kuala Lumpur MalaysiaDepartment of Family Medicine, Faculty of Medicine and Health Sciences Universiti Putra Malaysia (UPM) Kuala Lumpur MalaysiaDepartment of Family Medicine, Faculty of Medicine and Health Sciences Universiti Putra Malaysia (UPM) Kuala Lumpur MalaysiaDepartment of Clinical Oncology, Faculty of Medicine University of Malaya (UM) Kuala Lumpur MalaysiaClinical Service Department Hospis Malaysia Kuala Lumpur MalaysiaDepartment of Clinical Oncology, Faculty of Medicine University of Malaya (UM) Kuala Lumpur MalaysiaDepartment of Surgery, Universiti Malaya Cancer Research Institute, Faculty of Medicine University of Malaya (UM) Kuala Lumpur MalaysiaCancer Research Malaysia (CRMY) Subang Jaya Selangor MalaysiaDepartment of Primary Care Medicine, Faculty of Medicine University of Malaya (UM) Kuala Lumpur MalaysiaCancer Research Malaysia (CRMY) Subang Jaya Selangor MalaysiaAbstract Background Shared decision‐making has been shown to improve the quality of life in metastatic breast cancer patients in high‐literacy and high‐resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision‐making implementation and the barriers encountered in an Asian setting where societal norms predominate and physician decision‐making is at the forefront. This paper aims to identify (1) barriers to practising shared decision‐making faced by healthcare professionals and patients and (2) strategies for implementing shared decision‐making in the context of metastatic breast cancer management in Malaysia. Methods We conducted a qualitative study involving 12 patients diagnosed with metastatic breast cancer, 16 healthcare professionals and 5 policymakers from surgical and oncology departments at public healthcare centres in Malaysia. Semi‐structured in‐depth interviews and focus group discussions were conducted. The interviews were recorded, transcribed verbatim and analysed using the thematic approach. Nvivo software was used to manage and analyse the data. Results Five main themes emerged from the study: healthcare provider–patient communication, workforce availability, cultural and belief systems, goals of care and paternalism versus autonomy. Other strategies proposed to overcome barriers to implementing shared decision‐making were training of healthcare professionals and empowering nurses to manage patients' psychosocial issues. Conclusion This study found that practising shared decision‐making in the public health sector remains challenging when managing patients with metastatic breast cancer. The utilization of decision‐making tools, patient empowerment and healthcare provider training may help address the system and healthcare provider–patient barriers identified in this study. Patient or Public Contribution Patients were involved in the study design, recruitment and analysis.https://doi.org/10.1111/hex.13590metastatic breast cancerqualitative researchshared decision‐making |
| spellingShingle | Ping Yein Lee Ai Theng Cheong Sazlina Shariff Ghazali Aneesa Abdul Rashid Siu Ching Ong Soo Ying Ong Adlinda Alip McCarthy Sylvia May Feng Chen Nur Aishah Taib Maheswari Jaganathan Chirk Jenn Ng Soo‐Hwang Teo Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country Health Expectations metastatic breast cancer qualitative research shared decision‐making |
| title | Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country |
| title_full | Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country |
| title_fullStr | Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country |
| title_full_unstemmed | Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country |
| title_short | Barriers of and strategies for shared decision‐making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country |
| title_sort | barriers of and strategies for shared decision making implementation in the care of metastatic breast cancer a qualitative study among patients and healthcare professionals in an asian country |
| topic | metastatic breast cancer qualitative research shared decision‐making |
| url | https://doi.org/10.1111/hex.13590 |
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