Patient with cancer : Their preferences and experiences of participation in treatment and care decisions
Year: 2004
Type: dissertation
Study design: Observational Study
Abstract: The main aim of this thesis was to investigate preferences for \nparticipating in treatment decision-making in patients with colorectal \ncancer before treatment and at a one-year followup and to compare the \nrelationship between these preferences and coping factors. An additional \naim was to explore the patients' meaning of illness and their experiences \nof decision-making concerning treatment and care. \n \n \n \nThe aim of study I was to examine preferences about the degree of \nparticipation in treatment decisions among a group of patients with \ncolorectal cancer and to relate the results to the patients' sense of \ncoherence and the meaning they attributed to the disease. The results \nshow that 62 % of the patients preferred a collaborative role in \ntreatment decisions. There were no statistically significant differences \nbetween the preferred roles with respect to the patients' sense of \ncoherence and the meaning they attributed to the disease. \n \n \n \nThe aim of study II was to compare preferences for participation in \ntreatment decisions before and one-year after surgery with the patients' \nsense of coherence. The results show that before surgery 71 % of the \npatients and at the one-year follow-up 75 % of the patients' preferred \ncollaborative roles in decision-making. Sixty-four percent maintained \ntheir preferred roles from before surgery to the one-year follow-up. \nThere were no statistically significant differences between the preferred \nroles with respect to the patients' sense of coherence either before \nsurgery or at follow-up. \n \n \n \nThe aim of study III was to explore emotional and interactional \nperspectives of the meaning of illness, for a one-year illness period \nfrom the time of receiving the cancer diagnosis. The constant comparative \nmethod was used to analyse data. The meaning of the illness was expressed \nin the main theme, 'Attempting to find meaning in illness in order to \nachieve emotional coherence'. The theme consists of two dimensions; \nunified and dichotomised embodiment. The sub-themes of unified embodiment \ndimension were: gratefulness, confidence in oneself and others, looking \nforward, and creating a new future. The sub-themes of the dichotomised \ndimension embodiment were; altered self-worth, loss of temporality, \ninfringement, and loss of integrity. \n \n \n \nThe aim of study IV was to explore and conceptualise the experiences of \nparticipating in decisions. The constant comparative method was used. The \nconcept of participation was formulated into the main theme as 'Compliant \nparticipation in serious decisions'. The theme comprised two variations: \ncomplying with participation and complying without participation. \nComplying with participating was characterised by a high level of \nselfconfidence and selfcompetence and was associated refers to open \ndialogues between the participant, physician and nurse. Complying without \nparticipating was characterised by the participants' uncertainty and \nbeing urged to submit to decisions with a minimum delay without having \ntime to consider the information provided or influence the treatment and \ncare process. \n \n \n \nConclusion: A patient's preference in participation in treatment and care \ndecision-making seems to be preconditioned by many factors, above all \ntheir understanding of the situation, information attained, the meaning \nthey ascribe to the illness as well as interpersonal factors. To \nparticipate (or choosing not to participate) builds on open and affirming \ndialogues, information and knowledge about the illness. This helps the \npatient to experience a sense of coherence and selfcontrol. The findings \nsuggest that support of a patient's participation in treatment and care \ndecision-making should aim to minimise or prevent distress and \nuncertainty. Increased patient participation in treatment and care \ndecision making is interpreted as a health promoting way to cope with \ntheir illness. Further research is required to illuminate social and \ninterpersonal aspects of patient participation in decision-making in \norder to develop appropriate ways of providing emotional support to this \ngroup of patients.
Source: Figshare
Author: Ethel Ramfelt
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1576868929