Patient decision aids (PtDAs) are helpful to patients making decisions regarding first-line treatment of cancer, according to a recent review. Results of this analysis were reported in the journal Cancer Nursing.
“Our synthesized findings of the 16 included studies indicated that most patients find PtDAs beneficial in terms of understanding treatment options and gaining clarity on their own values and preferences,” the researchers explained in their report.
The analysis incorporated findings from qualitative studies identified through CINAHL, Ovid-MEDLINE, APA PsycINFO, and EMBASE databases that included adults with a range of cancer diagnoses. Using search terms centered on shared decision-making, patient involvement, and other related terms, the researchers set out to examine reported experiences of patients using PtDAs in decision-making for initial cancer treatment.
There were 16 studies included in the analysis, with publication dates ranging from 2005 through 2020. PtDAs were found to improve understanding of treatment options as well as patient values and preferences. PtDAs could also provide a platform for communicating about concerns, receiving support, and communicating with healthcare providers. They also appeared to support engagement of the patient and family in decision-making and helped with recalling information and assessing satisfaction with decisions.
However, PtDAs posed challenges for some patients. For example, one study reported that patients had not had sufficient time to read the PtDA, and language barriers were also an obstacle. Additionally, a different study suggested patients did not have sufficient computer skills for navigating an Internet-based PtDA.
The researchers suggested that nurses employ 5 steps set forth by the Agency for Healthcare Research and Quality to facilitate shared decision-making with a patient. These include seeking patient participation, helping the patient in evaluating treatment options, assessing patient values and preferences, reaching a decision with the patient, and evaluating patient decisions.
This study demonstrated that PtDAs aid in addressing informational and emotional needs of patients during decision-making and that nurses can help patients make decisions in line with their values and preferences.
“The involvement of nurses in patients’ decision-making process for complex cancer treatment, along with the use of PtDAs, can meet the decisional needs of patients and improve their decisional outcomes,” concluded the researchers.
Longcoy LH, Mathew A, Jang MK, Mayahara M, Doorenbos AZ. Experiences of using patient decision aids for decisions about cancer treatment: a meta-aggregation of qualitative studies. Cancer Nurs. Published online July 11, 2023. doi:10.1097/NCC.0000000000001263