Factors Influencing Implementation Of Shared Medical Decision Making In Patients With Cancer

Abstract

Huei-Lan Chang,1 Fang-Shan Li,1 Chiou-Fen Lin2,3 1Nursing Department, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan; 2College of Nursing, School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan; 3Department of Nursing, Shuang Ho Hospital, Taipei Medical University, Taipei, TaiwanCorrespondence: Chiou-Fen LinCollege of Nursing, School of Gerontology Health Management, Taipei Medical University, 250 Wu-Hsing Street, Taipei City 110, TaiwanTel [phone] Ext. 6341Email [email protected]: Shared decision making promotes patient participation in medical decisions. This study aims to explore the decision-making situation and influencing factors in patients with cancer.Patients and methods: A cross-sectional descriptive study was conducted for patient with cancers in regional teaching hospitals in northern Taiwan using short-form Mandarin Health Literacy Scale (s-MHLS) and Shared Decision Making Questionnaire (SDM-Q-9), with total 120 cases collected from January 15 to April 30, 2018.Results: Overall health literacy in patients with cancer is 86.52%, and degree of shared decision making is 89.63%; higher education level indicated better health literacy (p<0.001); health literacy is significantly correlated with Shared decision making (r=0.258, p=0.004). Increasing education level by one grade elevated health literacy by 0.623. Expanding health knowledge by one source increased health literacy by 0.307 points, one point increase in health literacy enhanced shared decision making by 0.128 points. Using path analysis, we found education level affects health literacy, which in turn influences shared decision making.Conclusion: Improving health literacy is indispensable to promote patient participation in shared decision making in the highly professional medical field. Education level directly affects health literacy; therefore, in the future, providing disease-matching health education is crucial for patients with lower education levels to enhance their health literacy. Health literacy directly affects shared decision making; therefore, more active assistance in achieving patient health literacy is crucial to implement shared decision making.Keywords: health literacy, shared decision making, patient–physician communication, patients with cancer

Keywords

• health literacy
• shared decision making
• patient-physician communication
• patients with cancer.