Does the use of shared decision-making consultation behaviors increase treatment decision-making satisfaction among Chinese women facing decision for breast cancer surgery?

Patient Educ Couns. 2014 Feb;94(2):243-9. doi: 10.1016/j.pec.2013.11.006. Epub 2013 Nov 28.


Objective: To assess the extent to which breast surgical consultations used shared decision making (SDM), identify factors associated with use of SDM, and assess if using SDM increases decision-making satisfaction.

Methods: Two hundred and eighty-three video-recorded diagnostic-treatment decision consultations between breast surgeons and women with breast cancer were assessed using the Decision Analysis System for Oncology (DAS-O) coding system designed for assessing SDM behaviors. Women completed a questionnaire at pre-consultation, one-week post-consultation and one-month post-surgery. Patient outcomes included decision conflict, patient satisfaction with medical consultation, and decision regret.

Results: Overall, the level of SDM behaviors was low. The extent of SDM behavior within consultation was related to greater consultation duration (p<0.001), more than one treatment being offered (p<0.001), and fewer questions raised by patients/companions (p<0.05). While use of SDM consultation did not influence post-consultation decision conflict, it increased satisfaction with information given and explained, patients' feelings of trust and confidence in their surgeons, and reduced post-surgical decision regret.

Conclusion: These breast surgical consultations mostly adopted informed treatment decision-making approaches. Using SDM improved patient consultation and decision satisfaction.

Practice implications: The study findings highlight a need to reinforce the importance of SDM in consultations among breast surgeons.

Keywords: Breast cancer; Breast surgical consultation; Chinese; Shared decision making.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asian Continental Ancestry Group / psychology*
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / surgery
  • China
  • Decision Making*
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Middle Aged
  • Outcome and Process Assessment, Health Care*
  • Patient Participation*
  • Patient Satisfaction / ethnology*
  • Personal Satisfaction
  • Physician-Patient Relations
  • Referral and Consultation
  • Surveys and Questionnaires
  • Tape Recording