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Barriers and facilitators for shared decision-making in oncology inpatient practice: an explorative study of the healthcare providers’ perspective

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Background

In cancer care, shared decision-making (SDM) is especially relevant as different treatment options have a different impact on prognosis and patients’ quality of life. However, evidence suggests that SDM is not routinely practiced. Furthermore, literature is mostly focussed on the outpatient setting. This study explored healthcare providers’ perspectives on SDM for oncology inpatients and identified barriers and facilitators.

Method

In this qualitative study, focus groups and semi-structured interviews were held with five nurses, eleven residents, four oncologists, and two healthcare managers caring for oncology inpatients of the Elisabeth-TweeSteden hospital.

Results

Healthcare professionals do not always clearly state when a decision is required. On a patient level, comprehension barriers, language barrier, and distraction by emotions or sickness are recognized as barriers for adequate patient’s communication. On a healthcare professional level, having awareness to inform about choices, being able to transfer this information, connecting to the patient, having substantial experience, and a good patient-physician relationship were facilitators. On an organizational, level, time, private rooms, continuity in care, and suboptimal use of the electronic health record were barriers.

Conclusion

While SDM is recognized and valued, its implementation is inconsistent. Addressing the several barriers found and optimizing the facilitators is imperative. A start could be by raising awareness for SDM in the inpatient setting, adding SDM as part of the care pathway, stating to patients when a decision is required, reporting on the SDM process in the electronic health record, and describing the nurses’ role in SDM.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Internal Medicine, ETZ, Tilburg, The Netherlands

    Milou Steenbergen & Laurens V. Beerepoot

  2. Department of Medical Psychology, ETZ, Tilburg, The Netherlands

    Jolanda de Vries & Marjan J. Traa

  3. CoRPS, Tilburg School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

    Jolanda de Vries

  4. ETZ, Tilburg, The Netherlands

    Rita Arts

Authors
  1. Milou Steenbergen
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  2. Jolanda de Vries
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  3. Rita Arts
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  4. Laurens V. Beerepoot
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  5. Marjan J. Traa
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Contributions

M. Steenbergen (MS) conceived and designed the analysis, collected data, analyzed data, and wrote the paper. M. J. Traa (MJ) guided the entire process and participated in the data analysis and in writing the paper. Prof. J. de Vries, R. Arts, and L.V. Beerepoot participated in writing the paper. The authors would like to thank T. van der Water (TW) for transcribing.

Corresponding author

Correspondence to Milou Steenbergen.

Ethics declarations

Ethics approval

Ethical approval is obtained from the Board of Directors of the Elisabeth-TweeSteden hospital (protocol ID: L0841.2019).

Consent to participate

Informed consent was obtained from all participants included in the study.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Steenbergen, M., de Vries, J., Arts, R. et al. Barriers and facilitators for shared decision-making in oncology inpatient practice: an explorative study of the healthcare providers’ perspective. Support Care Cancer 30, 3925–3931 (2022). https://doi.org/10.1007/s00520-022-06820-1

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  • DOI: https://doi.org/10.1007/s00520-022-06820-1

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