Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer: A qualitative research

Abstract

Abstract Objective There was increasingly demand of participation in surgical decision-making among Chinese patients with prostate cancer. However, due to the complex healthcare system and advanced care settings, it is quite challenging for the patients to gain sufficient support from the institute and the government. This research will investigate the factors that impact the degree of participation in surgical decision-making among Chinese prostate cancer patients. Methods A phenomenological approach of qualitative research based on the results of semi-structured interviews were adopted, to explore the influencing factors which hinder the participation in surgical decision-making. COREQ reporting guidelines were utilized. Up to 160 post-operative patients who had undergone radical prostatectomy along with 68 medical and nursing staffs, were purposively recruited in this research. This retrospective study was carried out from September 2018 to August 2019. After recording and transcribing the interviews, the interview materials were evaluated via the Colaizzi s seven step approach and the QSR Novivo10.0 software to analyze the interview content. Results According to the analysis and summary of the interviews, there are three factors affecting the degree of participation in surgical decision-making: Firstly, insufficient communication time between medical staff and patients before surgery, lack of communication skills, difficulty in developing patient assisted decision-making tools, lack of career experience of young medical staff, and inconsistent in the availability of resources between different hospitals, resulting in insufficient information provided by medical and nursing staff. Secondly, the cognitive level of decision-making among patients is relatively low due to poor psychological endurance, insufficient amount of education, senility and less knowledge and information demand. And ultimately, decisions are constantly made by family members with/without patients. Conclusions The degree of participation of Chinese prostate cancer patients in the surgical decision-making had much space for improvement.