Information Needs and Decisional Preferences Among Women with Ovarian Cancer
Information Needs and Decisional Preferences Among Women with Ovarian Cancer
ABSTRACT & COMMENTARY
Synopsis: A high proportion of Canadian women with ovarian cancer preferred both a high degree of information and decisional involvement about their ovarian cancer management.
Source: Stewart DE, et al. Gynecol Oncol 2000;77:357-361.
Stewart and colleagues conducted a questionnaire study of English-speaking women diagnosed with ovarian cancer attending ambulatory tertiary care treatment and follow-up clinics at a Canadian university general hospital, and at a comprehensive cancer center. Questionnaires were completed by 105 women with ovarian cancer. Their mean age was 56. Most were married, well educated, and considered their health status to be excellent or good, even though more than 60% had metastatic disease. More than 80% of these women wanted detailed information about ovarian cancer during the diagnosis, treatment, and posttreatment stages of their disease. In particular, they wanted information pertaining to the disease, treatment, and self-care issues. Approximately 60% of women preferred to share decision-making with their doctors at every stage of the illness. Psychological variables and disease severity were found to influence information needs and decisional preferences. In general, the more psychologically distressed the women, the more information they wanted about coping strategies and the more serious the illness, the more shared decision-making was desired. Stewart et al concluded that these findings present a challenge to health care providers in more adequately meeting the individual information needs of women with ovarian cancer and involving them to the extent that they wish in the decision-making process.
Comment by David M. Gershenson, MD
Attitudes among ovarian cancer patients and their physicians have changed dramatically over the past few decades. It was not that long ago that physicians were very paternalistic and provided their patients and families almost no information regarding outcome and prognosis. And, for the most part, patients were excluded from the decision-making process. There has been an increasing desire by patients and their families to obtain medical information and to participate in treatment preferences and decisionmaking. The findings of this study confirm our impressions of these trends. However, we must be careful not to over-interpret the meaning of these results. For instance, the subjects of this study were principally Caucasian and well educated. There undoubtedly are significant cultural differences. Importantly, not all women desire detailed information regarding their prognosis. This area is the most difficult to assess. Therefore, physicians need to inquire about the patient’s preference before discussing details of outcome.
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