86 | Chapter 3 of the relationship between the patient and caregiver could provide valuable insights. Exploring this relationship could enhance our understanding of patient involvement, and future research could incorporate qualitative study designs to explore this aspect further58. When exploring both levels of SDM, a discrepancy appears to exist between surgeons’ and patients’ perception of SDM and the extent to which we observed SDM being employed. As expected, both surgeons and patients perceived SDM to be adequately implemented during consultation, which is consistent with previous research33, 34, 38, 39, 53, 54, indicating that surgeons and patients tend to overestimate the extent of SDM in their consultations. This discrepancy between perception and observation may stem from a lack of complete understanding of what SDM truly involves, leading surgeons and patients to believe that SDM has occurred59, 60. Consequently, they might have misinterpreted aspects of counseling as SDM, whereas objective scoring may indicate otherwise. Additionally, they might have mistaken the mere inclusion of some SDM-related components, such as discussing patients’ goals, values and preferences, with the quality of discussing them. Another explanation for this discrepancy may be that surgeons and patients reported on their overall satisfaction with the consultation rather than on the perceived level of SDM. However, given the complexity and potential impact of the treatment decisions, it is important to improve the decision-making process with HN patients, especially since SDM has been shown to be beneficial for various patient and healthcare-related outcomes5-10. As such, given the overall satisfaction of surgeons and patients with the current state of the decision-making process in HN oncology, we recommend future research to explore these considerations. Furthermore, patients’ preferences for involvement in decision-making vary widely, and discrepancies between the preferred and perceived level of involvement are often observed14, 33, 53, 61. In our study, the surgeons almost never explicitly asked the patient to what extent they wished to be involved in the decision-making. Similarly, we found this discordance in surgeons’ assumptions of patients’ preference for involvement in decision-making and patients’ actual preference, with surgeons overestimating patients’ preferences eight times and underestimating them five times. This highlights the need for more attention to patients’ involvement preferences by HN surgeons, especially since discordance between preferred and actual involvement has been reported to substantially affect diverse patient outcomes, such as patient satisfaction, patients’ understanding of information, fulfillment of information needs62, and both physical and emotional QoL63.
RkJQdWJsaXNoZXIy MTk4NDMw