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Current Oncology
Special Issues
Oncological Decision-Making in Theory and Practice
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Oncological Decision-Making in Theory and Practice

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Psychosocial Oncology".

Deadline for manuscript submissions: closed (25 November 2022) | Viewed by 12750

Special Issue Editor

Prof. Dr. Gabriella Pravettoni

E-Mail Website
Guest Editor
1. Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
2. Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
Interests: psychoncology; cognitive processes; decision making and error prevention; medical humanities; health and centrality of patient
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Research has shown that a diagnosis of cancer can affect patients (and their caregivers) psychologically as well as physically. Particularly important are the decision-making processes in which patients are constantly engaged, from diagnosis to post-remission, as their choices can change their trajectories of recovery and well-being. Health-related decisions should be based on the available clinical evidence while considering clinician experience and patient preferences and values. The patient’s perspective is especially relevant in the case of preference-sensitive decisions, namely, choosing among several available options without evidence for the superiority of one alternative over another. In these situations, the best choice depends on how patients value the risks and benefits of each alternative. Thus, healthcare professionals should provide patients and their caregivers with understandable and accurate information and work together with them to make health-related decisions, including prevention, diagnosis, and treatment.

This Special Issue aims to highlight recent findings on the topic of decision-making processes in oncology. Specifically, we welcome submissions of research and review articles contributing to the understanding of the overall psychological aspects related to medical decision-making, both from the perspective of patients with cancer and their caregivers, as well as from the clinicians’ point of view. Submissions from all fields of psychology and oncology regarding these issues are welcome, with a particular preference for contributions regarding the implementation and the effectiveness of eHealth and mHealth tools to support better decisions, the investigation of bias and heuristics in decision-making, and the understanding of the doctor–patient interaction and its effect on decision-making.

Prof. Dr. Gabriella Pravettoni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • decision-making
  • cognitive bias
  • shared decision-making
  • patient involvement
  • clinical decision support systems

Published Papers (6 papers)

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Research

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11 pages, 632 KiB  
Article
Assessing the Functional Accessibility, Actionability, and Quality of Patient Education Materials from Canadian Cancer Agencies
by Courtney van Ballegooie, Devon Heroux, Peter Hoang and Sarthak Garg
Curr. Oncol. 2023, 30(2), 1439-1449; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol30020110 - 19 Jan 2023
Cited by 2 | Viewed by 1711
Abstract
Patient education materials (PEM)s were extracted from provincial cancer agencies to determine their organizational health literacy by evaluating the quality, actionability, and functional accessibility (e.g., readability and understandability) of their PEMs. PEMs from 10 provincial agencies were assessed for their grade reading level [...] Read more.
Patient education materials (PEM)s were extracted from provincial cancer agencies to determine their organizational health literacy by evaluating the quality, actionability, and functional accessibility (e.g., readability and understandability) of their PEMs. PEMs from 10 provincial agencies were assessed for their grade reading level (GRL), using eight numerical and two graphical readability scales, and underwent a difficult word analysis. The agencies were assessed for PEM quality using two methods (JAMA benchmarks and DISCERN), while actionability and understandability were assessed using the Patient Education Materials Assessment Tool (PEMAT). Seven hundred and eighty-six PEMs were analyzed. The overall average GRL was 9.3 ± 2.1, which is above the recommended 7th GRL for health information. The difficult word analysis showed that 15.4% ± 5.1% of texts contained complex words, 35.8% ± 6.8% of texts contained long words, and 24.2% ± 6.6% of texts contained unfamiliar words. Additionally, there was high overlap between the most frequently identified difficult words in the PEMs and the most frequently misunderstood words by cancer patients identified in the literature. Regarding quality indicators, no agency displayed all four indicators according to the JAMA benchmarks and DISCERN scores ranged between 38 (poor) to 66 (excellent). PEMAT scores ranged between 68% to 88% for understandability and 57% to 88% for actionability. PEMs continue to be written at a level above the recommended GRL across all provinces, and there was overall high variability in the quality, understandability, and actionability of PEMs among provincial agencies. This represents an opportunity to optimize materials, thus ensuring understanding by a wider audience and improving health literacy among Canadian cancer patients. Full article
(This article belongs to the Special Issue Oncological Decision-Making in Theory and Practice)
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14 pages, 302 KiB  
Article
Effects and Working Mechanisms of a Multilevel Implementation Program for Applying Shared Decision-Making while Discussing Systemic Treatment in Breast Cancer
by Haske van Veenendaal, Loes J. Peters, Esther van Weele, Mathijs P. Hendriks, Maaike Schuurman, Ella Visserman, Carina G. J. M. Hilders and Dirk T. Ubbink
Curr. Oncol. 2023, 30(1), 236-249; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol30010019 - 23 Dec 2022
Cited by 4 | Viewed by 1955
Abstract
Background: Enhancing the application of shared decision-making (SDM) is critical for integrating patient preferences in breast cancer treatment choices. We investigated the effect of an adapted multilevel SDM implementation program in breast cancer care. Methods: Breast cancer patients qualifying for (neo)adjuvant systemic treatment [...] Read more.
Background: Enhancing the application of shared decision-making (SDM) is critical for integrating patient preferences in breast cancer treatment choices. We investigated the effect of an adapted multilevel SDM implementation program in breast cancer care. Methods: Breast cancer patients qualifying for (neo)adjuvant systemic treatment were included in a multicenter before–after study. Consultations were audio recorded between June 2018 and July 2019 and analyzed using the five-item Observing Patient Involvement in Decision-Making (OPTION-5) instrument to score SDM application by clinicians. The Shared Decision-Making Questionnaire (SDM-Q-9) was used to rate patients’ perceived SDM level. Consultation duration, decision types, number of options discussed and consultations per patient were monitored. Regression analysis was used to investigate the correlated variables and program components. Results: Mean OPTION-5 scores increased from 33.9 (n = 63) before implementation to 54.3 (n = 49) after implementation (p < 0.001). The SDM-Q-9 scores did not change: 91.1 (n = 51) at baseline versus 88.9 (n = 23) after implementation (p = 0.81). Without increasing consultation time, clinicians discussed more options after implementation. The regression analysis showed that exposure to the implementation program, redistribution of tasks and discussing feedback from consultations was associated with a higher level of SDM. Conclusion: The multilevel program helped clinicians achieve clinically relevant improvement in SDM, especially when it is tailored to (individuals in) teams and includes (e-)training, discussing feedback on consultations and redistribution of tasks. Full article
(This article belongs to the Special Issue Oncological Decision-Making in Theory and Practice)
15 pages, 1707 KiB  
Article
Tobacco Smoking Behaviors in Cancer Survivors: The Mediation Effect of Personality and Emotional Intelligence
by Ilaria Durosini, Marianna Masiero, Chiara Casini and Gabriella Pravettoni
Curr. Oncol. 2022, 29(12), 9437-9451; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29120742 - 02 Dec 2022
Viewed by 1442
Abstract
The smoking behaviour of patients following a cancer diagnosis is a critical risk factor for several physical diseases; it can increase the risk of second primary tumors and lower cancer treatment efficacy. Despite this, a great number of survivors continue to smoke after [...] Read more.
The smoking behaviour of patients following a cancer diagnosis is a critical risk factor for several physical diseases; it can increase the risk of second primary tumors and lower cancer treatment efficacy. Despite this, a great number of survivors continue to smoke after the diagnosis. This observational, cross-sectional on-line study aimed to assess the relationship between the impact of cancer diagnosis on survivors and their smoking behavior, and whether emotional intelligence and personality might mediate this relationship. Ninety-four Italian survivors completed a set of questionnaires: Big Five Inventory; Fagerström Test for Nicotine Dependence; Impact of Event Scale; Brief Emotional Intelligence Scale. The results obtained from the mediation analyses highlighted that the indirect effect on the relationship between the psychological impact of the diagnosis and smoking behaviors was partially mediated by neuroticism (Intrusion: 95% CI [0.00; 0.11]; Avoidance: 95% CI [0.00; 0.18]). Additionally, the data suggested that the relationship between the psychological impact of the diagnosis and smoking behaviors was partially mediated by the utilization of emotions dimension of emotional intelligence (Intrusion: 95% CI [0.00; 0.10]; Avoidance: 95% CI [0.00; 0.22]). Overall, this study suggests the importance of designing interventions to support smoking interruption based on the “mapping” of individual needs and emotional regulation strategies. Full article
(This article belongs to the Special Issue Oncological Decision-Making in Theory and Practice)
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14 pages, 487 KiB  
Article
Psychological Determinants of Men’s Adherence to Cascade Screening for BRCA1/2
by Giulia Ongaro, Serena Petrocchi, Mariarosaria Calvello, Bernardo Bonanni, Irene Feroce and Gabriella Pravettoni
Curr. Oncol. 2022, 29(4), 2490-2503; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol29040203 - 02 Apr 2022
Cited by 3 | Viewed by 2041
Abstract
BRCA1/2 germline mutations predispose carriers to an increased risk of breast, ovarian, prostate, pancreatic, and skin cancer. Men and women are equally likely to pass on or inherit the pathogenic variant. However, there is evidence that male relatives are less involved in cascade [...] Read more.
BRCA1/2 germline mutations predispose carriers to an increased risk of breast, ovarian, prostate, pancreatic, and skin cancer. Men and women are equally likely to pass on or inherit the pathogenic variant. However, there is evidence that male relatives are less involved in cascade screening than female ones. At the same time, little attention has been given to the research on psychological determinants of men’s adherence to cascade screening in BRCA1/2-positive families. Applying some principles of the Health Action Process Approach model, the present research tested a model of relationships on the adherence to BRCA1/2 cascade testing guidelines. The sample comprised 115 men’s first-degree relatives of women with verified germline mutations (Mage = 41.93; SD = 17.27). A pre–post test design was applied. Significant associations emerged between the intention to uptake BRCA1/2 genetic testing and age, parental status, breast cancer risk perception, self-referred outcome expectancies, perceived benefit, coping self-efficacy, and planning. Higher perceived benefit predicted increases in intention, and higher intention and coping self-efficacy predicted increases in planning. Intention was a positive total mediator of the relationship between benefit and planning. On a theoretical level, our findings partially supported the Health Action Process Approach as a valuable model based on which interventions could be developed in the context of cascade screening for BRCA1/2 genetic testing. Those results supported the importance of integrated genetic counselling sessions with a strict collaboration between geneticists and psychologists together with interventions planned to increase men’s self-monitoring ability to support their self-efficacy. Full article
(This article belongs to the Special Issue Oncological Decision-Making in Theory and Practice)
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Review

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12 pages, 565 KiB  
Review
The Psychosocial Impact of the Decision to Undergo Risk-Reducing Salpingo-Oophorectomy Surgery in BRCA Mutation Carriers and the Role of Physician-Patient Communication
by Ana C. Alves-Nogueira, Daniela Melo, Carlos Carona and Margarida Figueiredo-Dias
Curr. Oncol. 2023, 30(2), 2429-2440; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol30020185 - 17 Feb 2023
Cited by 1 | Viewed by 2103
Abstract
Risk-reducing bilateral salpingo-oophorectomy (RRSO) is an effective prophylactic surgery provided to premenopausal women carrying BRCA1 or BRCA2 mutations and presenting an increased risk of developing breast or ovarian cancer. This procedure is related to physiological, sexual, and psychosocial distress, which altogether increase uncertainty [...] Read more.
Risk-reducing bilateral salpingo-oophorectomy (RRSO) is an effective prophylactic surgery provided to premenopausal women carrying BRCA1 or BRCA2 mutations and presenting an increased risk of developing breast or ovarian cancer. This procedure is related to physiological, sexual, and psychosocial distress, which altogether increase uncertainty and complexity in the clinical decision-making process and post-surgery adaptation. Physician-patient communication (PPC) has been pointed out as a determinant factor in the decision-making to undergo RRSO, and the subsequent adjustment of women. However, studies examining the psychosocial impact of the decision-making process have been scarce and often lack clear theoretical frameworks. While the role of PPC in such processes has been highlighted in a few qualitative studies, there is a paucity of quantitative research addressing this question. Therefore, this narrative review, conducted using a multidisciplinary approach, was planned to: (1) present an updated medical background for RRSO; (2) analyze the psychosocial impact of the decision-making process within a theoretical framework of the Health Belief Model; and (3) discuss the role of PPC in such a decision-making process and in post-surgery. The collected research also enabled the recommendation of some additions to the existing clinical guidelines and the outlining of future research directions. Full article
(This article belongs to the Special Issue Oncological Decision-Making in Theory and Practice)
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Other

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21 pages, 1005 KiB  
Systematic Review
Caregiving and Shared Decision Making in Breast and Prostate Cancer Patients: A Systematic Review
by Clizia Cincidda, Silvia Francesca Maria Pizzoli, Giulia Ongaro, Serena Oliveri and Gabriella Pravettoni
Curr. Oncol. 2023, 30(1), 803-823; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol30010061 - 06 Jan 2023
Cited by 8 | Viewed by 2387
Abstract
Background: A cancer diagnosis can impact patients’ and caregivers’ lives, posing different challenging situations. In particular, breast cancer and prostate cancer are two types of cancer involving families and especially spouses in challenges linked with the diagnosis and treatment process. Caregivers are usually [...] Read more.
Background: A cancer diagnosis can impact patients’ and caregivers’ lives, posing different challenging situations. In particular, breast cancer and prostate cancer are two types of cancer involving families and especially spouses in challenges linked with the diagnosis and treatment process. Caregivers are usually involved in the treatment decision-making (TDM) process concerning patients’ clinical pathway, cancer treatment, and ongoing therapies. To date, no contributions provide an exhaustive overview of the role of caregivers in cancer care and their involvement in the TDM process related to the therapies. Methods: We performed a systematic review of caregiver and patients experiences and perceptions of caregiver involvement in cancer TDM. Articles were searched on Public/Publisher MEDLINE (PubMed), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System Online (Medline), and American Psychological Association APA PsycINFO. Results: 17 studies were included, 10 on prostate cancer and 7 on breast cancer. According to the reviewed studies, patients and caregivers experienced the cancer diagnosis with a sense of unity. Most patients preferred to have an active or collaborative role with caregivers in TDM, feeling it was important to consult or share the decision made with their caregivers. Caregivers preferred to collaborate with patients or let patients decide by themselves after considering their opinions. Caregiver involvement could have a positive influence on the patient’s medical decisions, even if cancer diagnosis and treatments overwhelmed patients and caregivers. Conclusions: These findings highlight the importance of using a perspective that focuses on the relationship between a patient and caregivers when they receive a cancer diagnosis and have to make a treatment decision. Targeting caregiver–patient dyads, rather than individuals, is important since a supported relationship could have a protective effect on psychological distress, quality of life (QOL), and relationship satisfaction. Moreover, dyads may benefit from interventions that focus on the needs of both the patient and caregiver. Full article
(This article belongs to the Special Issue Oncological Decision-Making in Theory and Practice)
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