Is patient behavior during consultation associated with shared decision-making? A study of patients' questions, cues and concerns in relation to observed shared decision-making in a cancer outpatient clinic.

Abstract

To explore how cancer patients actively participate in consultations by asking questions and expressing emotional cues/concerns and to what extent this is associated with physician shared decision making (SDM) behavior. This observational study included audio recordings of 31 primary consultation with patients at the Oncology Outpatient Clinic at the University Hospital of North Norway. The content (topics) and frequency of health related questions from patients/caregivers were registered along with emotional cues and concerns (VR-CoDES) and observed shared decision-making (OPTION). Patient reported outcomes were measured before and one week after the consultation. On average, 17 (SD 15) questions were asked, and 1.9 (SD 1.9) emotional cues and concerns were expressed by patients per consultation. The questions mainly pertained to treatment and practical issues. The mean OPTION score was 12 (SD 7.9) and was neither associated with questions nor emotional cues and concerns from patients. Although patients were active by asking questions, observed physician SDM behavior measured by OPTION was low and not associated with patient behavior during consultation. Further research on patientś influence on physician SDM behavior is needed.