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

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

Neeraj K Arora  1 , Kathryn E Weaver, Marla L Clayman, Ingrid Oakley-Girvan, Arnold L Potosky
Affiliations

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

Neeraj K Arora et al. Patient Educ Couns. 2009 Dec.

Abstract

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.

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Figures

Figure 1
Figure 1
Pathways linking physicians' decision-making style with cancer survivors' health-related quality of life
Figure 2
Figure 2
Unstandardized regression coefficients from the final mediation model linking physicians' decision-making style with cancer survivors' mental health (MCS scores) Footnote: ***p < 0.001, **p < 0.01, *p < 0.05, §p = 0.06 Paths from age to MCS, trust, uncertainty, and control as well as paths from number of comorbidities to MCS and control are not shown, but were all statistically significant (p<0.05). Correlations between self-efficacy and trust as well as between control and uncertainty are not shown but were included in the model.
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References

    1. Rowland JH, Bellizzi KM. Cancer survivors and survivorship research: a reflection on today's successes and tomorrow's challenges. Hematol Oncol Clin North Am. 2008;22:181–200. - PubMed
    1. Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns. 2006;60:301–12. - PubMed
    1. Butow PN, Maclean M, Dunn SM, Tattersall MHN, Boyer MJ. The dynamics of change: Cancer patients' preferences for information, involvement and support. Annals of Oncology. 1997;8:857–63. - PubMed
    1. Gattellari M, Butow PN, Tattersall MHN. Sharing decisions in cancer care. Soc Sci Med. 2001;52:1865–78. - PubMed
    1. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999;49:651–61. - PubMed

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