Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada.
Implement Sci. 2009 Dec 24;4:81. doi: 10.1186/1748-5908-4-81.
Colorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient-centred care, there has been little investigation of patient and physician shared decision-making preferences and practices or the outcomes associated with shared decision making in the context of colorectal cancer.
The aim of this study is to determine patient and physician attitudes towards the use of shared decision making in the setting of colorectal cancer.
Standard principles of qualitative research will be used to sample and interview 20 colorectal cancer patients in each of three tertiary care hospitals (n = 60) and 15 surgeons, radiation oncologists, and medical oncologists (n = 45) affiliated with cancer centres. The interview questions will be guided by a conceptual framework defining patient and physician factors that influence the shared decision-making process and associated outcomes in the setting of colorectal cancer. An inductive, grounded approach will be used by two investigators to independently analyze the interview transcripts. These investigators will meet to compare and achieve consensus on themes that will be tabulated to compare barriers, enablers, and outcomes of shared decision making by patient, physician, and contextual factors.
This study is the first to examine both patient and physician perspectives on the use of shared decision making for colorectal cancer in North America or elsewhere. It will provide a framework that can be used to describe the shared decision-making process and its outcomes, and evaluate strategies to facilitate this process for patients with colorectal cancer.
结直肠癌是全球癌症死亡的第三大主要原因，每年有超过 90 万人被诊断出患有结直肠癌，63.9 万人死于结直肠癌。尽管广泛倡导共享决策作为实现以患者为中心的护理的机制，但对于患者和医生在结直肠癌背景下的共享决策偏好和实践，以及与共享决策相关的结果，研究甚少。
本研究旨在确定患者和医生对在结直肠癌环境中使用共享决策的态度。
将使用定性研究的标准原则，在三家三级保健医院（n=60）中各抽样并访谈 20 名结直肠癌患者，在与癌症中心相关的 15 名外科医生、放射肿瘤学家和肿瘤内科医生（n=45）中各抽样并访谈 20 名。访谈问题将由一个概念框架指导，该框架定义了影响结直肠癌环境中共享决策过程和相关结果的患者和医生因素。两位研究人员将采用归纳、扎根的方法独立分析访谈记录。这两位研究人员将开会比较并就主题达成共识，这些主题将被制表，以比较患者、医生和背景因素对共享决策的障碍、促进因素和结果。
这项研究首次在北美或其他地方检查了患者和医生对结直肠癌使用共享决策的观点。它将提供一个框架，可用于描述共享决策过程及其结果，并评估为结直肠癌患者促进这一过程的策略。
