Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study
<p>Abstract</p> <p>Background</p> <p>Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despit...
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| Format: | Article |
| Language: | English |
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BMC
2008-02-01
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| Series: | BMC Public Health |
| Online Access: | http://www.biomedcentral.com/1471-2458/8/77 |
| _version_ | 1818556436006830080 |
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| author | Takahashi Miyako Watanabe Yoshiko Kai Ichiro |
| author_facet | Takahashi Miyako Watanabe Yoshiko Kai Ichiro |
| author_sort | Takahashi Miyako |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Japanese people regarding involvement in treatment-related decision-making are limited. The main objectives of this study were to (1) reveal the actual level of involvement of Japanese cancer patients in the treatment-related decision-making and their overall satisfaction with the decision-making process, and (2) consider the practical implications of increased satisfaction in cancer patients with regard to the decision-making process.</p> <p>Methods</p> <p>We conducted semi-structured interviews with 24 Japanese cancer patients who were recruited from a cancer self-help group in Tokyo. The interviews were qualitatively analysed using the approach described by Lofland and Lofland.</p> <p>Results</p> <p>The analyses of the patients' interviews focused on 2 aspects: (1) who made treatment-related decisions (the physician or the patient), and (2) the informants' overall satisfaction with the decision-making process. The analyses revealed the following 5 categories of decision-making: 'patient as the active decision maker', 'doctor selection', 'wilfully entrusting the physician', 'compelled decision-making', and 'surrendering decision-making'. While the informants under the first 3 categories were fairly satisfied with the decision-making process, those under the latter 2 were extremely dissatisfied. Informants' views regarding their preferred role in the decision-making process varied substantially from complete physician control to complete patient control; the key factor for their satisfaction was the relation between their preferred involvement in decision-making and their actual level of involvement, irrespective of who the decision maker was.</p> <p>Conclusion</p> <p>In order to increase patient satisfaction with regard to the treatment-related decision-making process, healthcare professionals in Japan must assess individual patient preferences and provide healthcare accordingly. Moreover, a better environment should be created in hospitals and in society to facilitate patients in expressing their preferences and appropriate resources need to be made available to facilitate their decision-making process.</p> |
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| format | Article |
| id | doaj.art-f8271eda455f49ca81f88af8a0c89eb6 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-13T23:47:19Z |
| publishDate | 2008-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-f8271eda455f49ca81f88af8a0c89eb62022-12-21T23:26:54ZengBMCBMC Public Health1471-24582008-02-01817710.1186/1471-2458-8-77Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative studyTakahashi MiyakoWatanabe YoshikoKai Ichiro<p>Abstract</p> <p>Background</p> <p>Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Japanese people regarding involvement in treatment-related decision-making are limited. The main objectives of this study were to (1) reveal the actual level of involvement of Japanese cancer patients in the treatment-related decision-making and their overall satisfaction with the decision-making process, and (2) consider the practical implications of increased satisfaction in cancer patients with regard to the decision-making process.</p> <p>Methods</p> <p>We conducted semi-structured interviews with 24 Japanese cancer patients who were recruited from a cancer self-help group in Tokyo. The interviews were qualitatively analysed using the approach described by Lofland and Lofland.</p> <p>Results</p> <p>The analyses of the patients' interviews focused on 2 aspects: (1) who made treatment-related decisions (the physician or the patient), and (2) the informants' overall satisfaction with the decision-making process. The analyses revealed the following 5 categories of decision-making: 'patient as the active decision maker', 'doctor selection', 'wilfully entrusting the physician', 'compelled decision-making', and 'surrendering decision-making'. While the informants under the first 3 categories were fairly satisfied with the decision-making process, those under the latter 2 were extremely dissatisfied. Informants' views regarding their preferred role in the decision-making process varied substantially from complete physician control to complete patient control; the key factor for their satisfaction was the relation between their preferred involvement in decision-making and their actual level of involvement, irrespective of who the decision maker was.</p> <p>Conclusion</p> <p>In order to increase patient satisfaction with regard to the treatment-related decision-making process, healthcare professionals in Japan must assess individual patient preferences and provide healthcare accordingly. Moreover, a better environment should be created in hospitals and in society to facilitate patients in expressing their preferences and appropriate resources need to be made available to facilitate their decision-making process.</p>http://www.biomedcentral.com/1471-2458/8/77 |
| spellingShingle | Takahashi Miyako Watanabe Yoshiko Kai Ichiro Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study BMC Public Health |
| title | Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study |
| title_full | Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study |
| title_fullStr | Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study |
| title_full_unstemmed | Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study |
| title_short | Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study |
| title_sort | japanese cancer patient participation in and satisfaction with treatment related decision making a qualitative study |
| url | http://www.biomedcentral.com/1471-2458/8/77 |
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