Physicians' decision-making style and psychosocial outcomes among cancer survivors

Patient Educ Couns. 2009 Dec;77(3):404-12. doi: 10.1016/j.pec.2009.10.004. Epub 2009 Nov 4.


Objective: We evaluated pathways linking physicians' decision-making style with cancer survivors' health-related quality of life (HRQOL).

Methods: We analyzed survey data from 623 survivors diagnosed with leukemia, colorectal, or bladder cancer in Northern California, 2-5 years prior to the study. Of these, 395 reported making a medical decision in the past 12 months and were asked about their physician's decision-making style. We evaluated the association of physician style with proximal communication outcomes (trust and participation self-efficacy), intermediate cognitive outcomes (perceived control and uncertainty), and distal health outcomes (physical and mental HRQOL).

Results: Overall, 54% of survivors reported a sub-optimal decision-making style for their physician. With the exception of physical health, physician style was associated with all proximal, intermediate, and distal outcomes (p< or =0.01). We identified two significant pathways by which a participatory physician style may be associated with survivors' mental health: (1) by increasing survivors' participation self-efficacy and thereby enhancing their perceptions of personal control (p<0.01); (2) by enhancing survivors' level of trust and thereby reducing their perceptions of uncertainty (p<0.05).

Conclusion: A participatory physician style may improve survivors' mental health by a complex two-step mechanism of improving survivors' proximal communication and intermediate cognitive outcomes.

Practice implications: Physicians who adopt a participatory decision-making style are likely to facilitate patient empowerment and enhance patients' HRQOL.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Colorectal Neoplasms*
  • Decision Making*
  • Female
  • Humans
  • Leukemia*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Physician-Patient Relations*
  • Physicians*
  • Psychometrics
  • Quality of Life
  • Stress, Psychological*
  • Urinary Bladder Neoplasms*