School of Nursing, University of British Columbia, Vancouver, Canada.
Patient Educ Couns. 2013 Mar;90(3):291-6. doi: 10.1016/j.pec.2012.02.018. Epub 2012 Mar 30.
To contribute to the evolving dialogue on optimizing cancer care communication through systematic analyzes of patients' perspectives.
Using constant comparative analysis, inductively derived thematic patterns of communication preferences for shared decision-making were drawn from individual interviews with 60 cancer patients.
Thematic patterns in how patients understand barriers and facilitators to communication within shared decision-making illuminate the basis for distinctive patient preferences and needs. Prevailing cancer communication considerations included focusing attention on the tone and setting of the consultation environment, the attitudinal climate within the consult, the specific approach to handling numerical/statistical information, and the critical messaging around hope. The patient accounts surfaced complex dynamics whereby the experiences of living with cancer permeated interpretations and enactment of the shared decision-making that is emerging as a dominant ideal of cancer care.
In our efforts to move beyond traditional paternalism, shared decision-making has been widely advocated as best practice in cancer communication. However, patient experiential evidence suggests the necessity of a careful balance between standardized approaches and respect for diversities.
Shared decision-making as a practice standard must be balanced against individual patient preferences.
通过系统分析患者的观点，为优化癌症护理沟通的不断发展的对话做出贡献。
使用恒定性比较分析，从 60 名癌症患者的个体访谈中得出关于共同决策的沟通偏好的主题模式。
患者对共同决策中沟通障碍和促进因素的理解的主题模式阐明了独特的患者偏好和需求的基础。普遍的癌症沟通考虑因素包括关注咨询环境的氛围和设置、咨询中的态度氛围、处理数字/统计信息的具体方法以及围绕希望的关键信息传递。患者的描述揭示了复杂的动态，即癌症患者的生活经历渗透到共同决策的解释和实施中，共同决策作为癌症护理的主导理想正在出现。
在努力超越传统的家长式作风的过程中，共同决策已被广泛倡导为癌症沟通的最佳实践。然而，患者体验证据表明，标准化方法和尊重多样性之间需要谨慎平衡。
作为实践标准的共同决策必须与个体患者的偏好相平衡。
