Navigating prostate cancer together: Partner involvement in shared decision-making.

Abstract

Relatives often participate in medical decision-making, yet many report feeling excluded rather than meaningfully involved. Research indicates that when relatives are actively engaged in patient care - aligned with their abilities and needs - it can enhance patient adherence, safety, and the overall experience for both patients and their relatives. Despite this, their role in Shared Decision-Making (SDM) remains underexplored. This study examines perceptions of meaningful partner involvement in medical decision-making during hospital consultations with prostate cancer patients. This qualitative study (N = 72) draws on field notes, focus group and individual interviews, and handwritten workshop responses. Participants include doctors, nurses, patients, and relatives, selected through purposive sampling. As partners comprised the majority of relatives present during consultations, the study focused on their experiences through interviews and workshops. All data sources strive to capture decision-making moments during consultations, using a hermeneutic-phenomenological approach to explore participants' lived experiences. The first key finding, 'Roles', underscores the crucial contributions partners make during consultations and throughout the disease trajectory around medical decision-making. The roles are illustrated by four sub-themes: 'listening', 'remembering', 'taking responsibility', 'being supportive'. The second finding, 'Mindsets', reveals that partners and patients approach decision-making with different perspectives, either exhibiting a 'worried and skeptical' or 'positive' mindset, while others display a 'need for knowledge' or 'reserved' attitude. Partners play a crucial role in a patient's journey through illness and in decision-making discussions. However, their own needs should be acknowledged and addressed throughout this process. Doctors and nurses need to be mindful of this dynamic during consultations. The findings offer valuable insight for doctors and nurses to enhance decision-making conversations involving relatives, extending their applicability beyond prostate cancer to other medical conditions.