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Decisional control preferences of patients with advanced cancer receiving palliative care

Published online by Cambridge University Press:  02 November 2017

Colombe Tricou ,
Sriram Yennu ,
Murielle Ruer ,
Eduardo Bruera  and
Marilène Filbet
Colombe Tricou
Affiliation:
Department of Palliative Medicine, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Sriram Yennu
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Murielle Ruer
Affiliation:
Department of Palliative Medicine, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Eduardo Bruera
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Marilène Filbet*
Affiliation:
Department of Palliative Medicine, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
*
Address correspondence and reprint requests to: Marilène Filbet, Department of Palliative Medicine, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France. E-mail: marilene.filbet@chu-lyon.fr.
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Abstract

Objective:

Understanding patients' decisional control preferences (DCPs) is important to improving the quality of care and the satisfaction of patients who have advanced cancer with their care. In addition to passive decisional control (i.e., the patient prefers his/her doctor or family caregiver to make a decision on their behalf) and active decisional control (i.e., the patient decides alone), shared decisional control, where patients and caregivers decide together, could be more appropriate. The primary aim of our study was to describe the decision-making process and the DCPs of patients with advanced cancer receiving palliative care in France.

Method:

We conducted a prospective survey with advanced cancer patients referred to a palliative care team in an outpatient setting. We collected information about patients' demographic and clinical characteristics using the Decision Control Preference Scale, the Satisfaction with the Decisions and Care questionnaire, and the Understanding of Illness questionnaire.

Results:

A total of 200 patients were evaluable. The median age was 63.5 years and 53.5% female. The cancers most commonly represented were gastrointestinal and breast. A total of 72 patients (36.2%) preferred active decisional control, 52 (26.1%) preferred shared decisional control, and 75 (37.7%) preferred passive decisional control. Younger age (p = 0.003), higher education (p < 0.001), and employment status (p = 0.046) were found to be associated with active or shared DCPs. Some 82% of patients were satisfied with the decision-making process, 35% of whom expressed wishes that did not match the actual decision-making process. Only 23% of patients thought they could be cured of their illness, and 47% thought that their treatment would “get rid of ” their disease.

Significance of Results:

The decision-making processes are shared in the three models of DCPs in our cohort of French patients with advanced cancer. Further prospective studies are needed.

Keywords

Palliative careAdvanced cancerDecisional control preferencesDecision-making process
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 5 , October 2018 , pp. 544 - 551
Copyright
Copyright © Cambridge University Press 2017 

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