Kusankha Pamodzi: Health Care Decision-Making Preferences Among Patients with Cancer in Malawi

Abstract

Background: Oncology teams are encouraged to include patient preferences and goals of care in determining appropriate treatment courses. There are no existing data from Malawi exploring decision-making preferences among cancer patients. Methods: In the oncology clinic in Lilongwe, Malawi, 50 patients were surveyed for decision making. Results: Most participants (70%, n?=?35) preferred to engage in shared decision making regarding cancer treatment. About half (52%, n?=?24) did not feel that their medical team involved them in decision making and 64% (n?=?32) felt that they were never or only sometimes listened to by the medical team. Nearly all (94%, n?=?47) preferred to have their medical team inform them how likely treatments are to lead to cure. Conclusions: Shared decision making was the preferred mode of treatment decision making by the majority of the surveyed cancer patients in Malawi. Cancer patients in Malawi may have similar preferences to cancer patients in other low-resource settings regarding decision making and communication.

Keywords

• cancer
• communication
• decision making
• goals of care
• Malawi