Iranian Cancer Patients Perceptions of Barriers to Participation in Decision-Making: Potential Impact on Patient-Centered Care

Naism Aminaie; Jila Mirlashari; Rebecca H Lehto; Marzieh Lashkari; Reza Negarandeh

doi:10.4103/apjon.apjon_11_19

Iranian Cancer Patients Perceptions of Barriers to Participation in Decision-Making: Potential Impact on Patient-Centered Care

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):372-380. doi: 10.4103/apjon.apjon_11_19.

Authors

Naism Aminaie¹, Jila Mirlashari^{2

3}, Rebecca H Lehto⁴, Marzieh Lashkari⁵, Reza Negarandeh⁶

Affiliations

¹ Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
³ Obstetric and Gynecology Department, University of British Colombia, Canada.
⁴ College of Nursing, Michigan State University, East Lansing, MI, USA.
⁵ Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Science, Tehran, Iran.
⁶ Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Objective: The purpose of this study was to explore perceptions about barriers to decision-making in Iranian patients with cancer about their care.

Methods: Utilizing a qualitative approach, semi-structured interviews were conducted with 15 cancer patients.

Results: Data analysis revealed four central categories reflecting patient perceptions about barriers that included medical dominance (uninformed decision-making, perceived inability to disagree secondary to despair, and patient objectification), healthcare system mistrust (physician, nurse, and medical center facility and equipment), healthcare system characteristics (services and facilities' limitations, poor communication, healthcare setting compulsion), and cultural barriers (feeling unfamiliar, insecurity in an unfamiliar environment, language barriers, limited attention to religious beliefs).

Conclusions: Barriers may impact the perceived ability of Iranian patients' with cancer ability to participate in decision-making regarding their care. Such barriers contain the potential to disrupt patient-centered care. Perceptions about barriers articulated by patients are modifiable. While some Iranian healthcare systems may have problematic challenges, targeted allocation of resources and education of healthcare providers convey strong possibilities to enhance patient-centered care.

Keywords: Cancer; decision-making; healthcare providers; patient care; patient-centered care; qualitative methods.