Table 1.
Examples of themes across components of shared decision making
| Patients | Physicians |
|---|---|
| Information too detailed | Information overwhelms patient |
| “Things in writing always help. Too much paper gets to be a whole lot though.” ‐75 y/o female pancreatic casncer |
“I don't want to give them a lot of information up front and overwhelm them with a lot of data.” ‐Oncologist |
| “They hand you the whole thing that has every single slide and I think I'm going to go back and read this and go over it but I never do.” ‐79 y/o female non hodgkin's lymphoma |
“We have lots of stuff… but I don't know that they read it and I do think that it's overwhelming.” ‐Surgeon |
| Information inadequate | Information easy to understand |
| “No one ever asked me what my background was so they could know what level of information I could receive.” ‐58 y/o Male colon cancer | “We have lots of written information; it's usually well understood by people with a high school diploma.” ‐Surgeon |
| “It was one of those things where I had to trust doctors and my gut and my heart, but I don't feel like I've been an educated patient.” ‐42 y/o female melanoma |
“We have lots of stuff from the American Cancer Society that we give them with all the information they need about chemotherapy and radiation.” ‐Surgeon |
| Patient autonomy | |
| “I would prefer to know that I am making the decision. I mean after all it is your body right?” ‐65 y/o female breast cancer | “I think it's most of the time their decision. You give them the data but in most cases, it's their decision.” ‐Oncologist |
|
“It was my decision. My husband was there, my son was there, and it was up to me… I decided.” ‐85 y/o female pancreatic cancer |
“I think that the patients need to have the final say because we may think we are doing the best for them but that may not be the case.” ‐Gastroenterologist |
| Communication of patient and physician priorities | |
| “You ought to be talked to about your self‐image, cancer changes your whole self‐image.” ‐64 y/o female breast CA | “If the choice is, you are going to have to wear a wig for a while but you are going to be around, I am much more into doing that” ‐Oncologist |
| “Not having the option was an option but not really, you know, everyone advised the chemo so I knew I had to have the chemo.” ‐75 y/o female pancreatic CA | “It's frustrating when you know what the right thing to do is but try to convince patients to see otherwise, there is a gap in knowledge between patients and physicians.” ‐Surgeon |
| Physician recommendation | |
|
“My doctor told me that I'm not going to come out of this unscathed, he convinced me that this was what was needed by saying if this was my mom or sister I would tell them to get it done.” ‐59 y/o female breast CA |
“I always tell them that the standard of care that I am able to offer you may not be something you want. I think you should go and get a second opinion.” ‐Surgeon |
| “Many people get frustrated when a doctor won't tell them what they recommend. And that is very hard for patients.” ‐69 y/o female breast CA | “I tried to put in my bias and make a recommendation with a patient a long time ago and the patient didn't like it.” ‐Gastroenterologist |
| “Sometimes, you have to put it on the line. “What do you think I ought to do?” I think a good physician will make a recommendation at that point. The patient deserves that and I think that in medicine, we have maybe gone a little far the other way now in the patient involvement.” ‐66 y/o female breast CA |
“I always try to stay really objective, it's hard to take your opinion completely out of the decision making, but I do it by following the data.” ‐Oncologist |