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Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country

Background Shared decision-making has been shown to improve the quality of life in metastatic breast cancer patients in high-literacy and high-resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision-making implement...

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Main Authors:	Lee, Ping Yein, Cheong, Ai Theng, Ghazali, Sazlina Shariff, Rashid, Aneesa Abdul, Ong, Siu Ching, Ong, Soo Ying, Alip, Adlinda, Sylvia, McCarthy, Chen, May Feng, Taib, Nur Aishah Mohd, Jaganathan, Maheswari, Ng, Chirk Jenn, Teo, Soo-Hwang
Format:	Article
Published:	Wiley 2022
Subjects:	RC0254 Neoplasms. Tumors. Oncology (including Cancer) RT Nursing
Online Access:	http://eprints.um.edu.my/46255/ https://doi.org/10.1111/hex.13590
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spelling	my.um.eprints.462552024-07-24T07:19:36Z http://eprints.um.edu.my/46255/ Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country Lee, Ping Yein Cheong, Ai Theng Ghazali, Sazlina Shariff Rashid, Aneesa Abdul Ong, Siu Ching Ong, Soo Ying Alip, Adlinda Sylvia, McCarthy Chen, May Feng Taib, Nur Aishah Mohd Jaganathan, Maheswari Ng, Chirk Jenn Teo, Soo-Hwang RC0254 Neoplasms. Tumors. Oncology (including Cancer) RT Nursing Background Shared decision-making has been shown to improve the quality of life in metastatic breast cancer patients in high-literacy and high-resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision-making implementation and the barriers encountered in an Asian setting where societal norms predominate and physician decision-making is at the forefront. This paper aims to identify (1) barriers to practising shared decision-making faced by healthcare professionals and patients and (2) strategies for implementing shared decision-making in the context of metastatic breast cancer management in Malaysia. Methods We conducted a qualitative study involving 12 patients diagnosed with metastatic breast cancer, 16 healthcare professionals and 5 policymakers from surgical and oncology departments at public healthcare centres in Malaysia. Semi-structured in-depth interviews and focus group discussions were conducted. The interviews were recorded, transcribed verbatim and analysed using the thematic approach. Nvivo software was used to manage and analyse the data. Results Five main themes emerged from the study: healthcare provider-patient communication, workforce availability, cultural and belief systems, goals of care and paternalism versus autonomy. Other strategies proposed to overcome barriers to implementing shared decision-making were training of healthcare professionals and empowering nurses to manage patients' psychosocial issues. Conclusion This study found that practising shared decision-making in the public health sector remains challenging when managing patients with metastatic breast cancer. The utilization of decision-making tools, patient empowerment and healthcare provider training may help address the system and healthcare provider-patient barriers identified in this study. Patient or Public Contribution Patients were involved in the study design, recruitment and analysis. Wiley 2022-12 Article PeerReviewed Lee, Ping Yein and Cheong, Ai Theng and Ghazali, Sazlina Shariff and Rashid, Aneesa Abdul and Ong, Siu Ching and Ong, Soo Ying and Alip, Adlinda and Sylvia, McCarthy and Chen, May Feng and Taib, Nur Aishah Mohd and Jaganathan, Maheswari and Ng, Chirk Jenn and Teo, Soo-Hwang (2022) Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country. Health Expectations, 25 (6). pp. 2837-2850. ISSN 1369-6513, DOI https://doi.org/10.1111/hex.13590 <https://doi.org/10.1111/hex.13590>. https://doi.org/10.1111/hex.13590 10.1111/hex.13590
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	RC0254 Neoplasms. Tumors. Oncology (including Cancer) RT Nursing
spellingShingle	RC0254 Neoplasms. Tumors. Oncology (including Cancer) RT Nursing Lee, Ping Yein Cheong, Ai Theng Ghazali, Sazlina Shariff Rashid, Aneesa Abdul Ong, Siu Ching Ong, Soo Ying Alip, Adlinda Sylvia, McCarthy Chen, May Feng Taib, Nur Aishah Mohd Jaganathan, Maheswari Ng, Chirk Jenn Teo, Soo-Hwang Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
description	Background Shared decision-making has been shown to improve the quality of life in metastatic breast cancer patients in high-literacy and high-resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision-making implementation and the barriers encountered in an Asian setting where societal norms predominate and physician decision-making is at the forefront. This paper aims to identify (1) barriers to practising shared decision-making faced by healthcare professionals and patients and (2) strategies for implementing shared decision-making in the context of metastatic breast cancer management in Malaysia. Methods We conducted a qualitative study involving 12 patients diagnosed with metastatic breast cancer, 16 healthcare professionals and 5 policymakers from surgical and oncology departments at public healthcare centres in Malaysia. Semi-structured in-depth interviews and focus group discussions were conducted. The interviews were recorded, transcribed verbatim and analysed using the thematic approach. Nvivo software was used to manage and analyse the data. Results Five main themes emerged from the study: healthcare provider-patient communication, workforce availability, cultural and belief systems, goals of care and paternalism versus autonomy. Other strategies proposed to overcome barriers to implementing shared decision-making were training of healthcare professionals and empowering nurses to manage patients' psychosocial issues. Conclusion This study found that practising shared decision-making in the public health sector remains challenging when managing patients with metastatic breast cancer. The utilization of decision-making tools, patient empowerment and healthcare provider training may help address the system and healthcare provider-patient barriers identified in this study. Patient or Public Contribution Patients were involved in the study design, recruitment and analysis.
format	Article
author	Lee, Ping Yein Cheong, Ai Theng Ghazali, Sazlina Shariff Rashid, Aneesa Abdul Ong, Siu Ching Ong, Soo Ying Alip, Adlinda Sylvia, McCarthy Chen, May Feng Taib, Nur Aishah Mohd Jaganathan, Maheswari Ng, Chirk Jenn Teo, Soo-Hwang
author_facet	Lee, Ping Yein Cheong, Ai Theng Ghazali, Sazlina Shariff Rashid, Aneesa Abdul Ong, Siu Ching Ong, Soo Ying Alip, Adlinda Sylvia, McCarthy Chen, May Feng Taib, Nur Aishah Mohd Jaganathan, Maheswari Ng, Chirk Jenn Teo, Soo-Hwang
author_sort	Lee, Ping Yein
title	Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
title_short	Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
title_full	Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
title_fullStr	Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
title_full_unstemmed	Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country
title_sort	barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: a qualitative study among patients and healthcare professionals in an asian country
publisher	Wiley
publishDate	2022
url	http://eprints.um.edu.my/46255/ https://doi.org/10.1111/hex.13590
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score	13.211869

Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country

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