Exploring Shared Decision-Making | 75 3 Introduction The dynamic, collaborative process of shared decision-making (SDM) allows patients, and when present, informal caregivers (hereafter: caregivers), to be involved during consultations1-4. Particularly important in applying SDM is the prioritization of the patient’s needs, values, goals of care, and preferences. When it comes to health- or treatment-related decisions, SDM has demonstrated several benefits, such as reducing the likelihood of decisional regret, higher patient satisfaction, lower healthcare costs, and ultimately potentially higher quality of life (QoL)5-10. Because of SDM, patients are generally better informed about benefits and risks, enabling healthcare providers and patients to choose treatment options that best suit patient needs1-4. In recent years, there has been a significant drive towards SDM in oncology healthcare. Patients are increasingly being viewed as partners, rather than passive recipients of treatment11. However, the implementation of SDM often proves to be challenging due to several factors, such as consultation time12, uncertainty or lack of consensus regarding the preferred treatment choice, or healthcare providers’ limited communication skills13. In addition, patients’ preferences for involvement in the decision-making process may differ significantly from the healthcare provider’s view of these preferences. Previous research has shown that patients’ preferences and perceptions of their involvement in decision-making vary14. Some patients prefer active involvement, while others opt for a more passive role14, 15. The application of SDM should acknowledge these potential differences by requiring healthcare providers to step in as mediators in order to collaboratively make treatment decisions16. Nevertheless, healthcare providers often find it difficult to involve patients in decision-making17, 18. Meanwhile, patients and their caregivers may encounter barriers that hinder their participation in the decisionmaking process, including limited knowledge as well as underestimating their own expertise relative to that of healthcare providers19, 20. Patients’ belief in the “doctor knows best” concept might pose significant hurdles in making collaborative treatment decisions. Consequently, weighing the potential benefits of treatment against the potential impact on their QoL is often very complex. Especially in the context of head and neck cancer (HNC), a delicate consideration of the potential advantages and drawbacks of each treatment option remains crucial, as comprehensive aggressive treatments, including surgery, radiation therapy and chemotherapy are frequently required21. These treatment modalities can have a major impact on patients’ QoL by potentially causing significant functional impairments related to speaking, swallowing, eating, or breathing22-24. Moreover, patients may experience pain, fatigue, and emotional distress, which can further affect their overall
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