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August 1, 2022BMJ OpenOpen Access

How do patients make decisions in the context of a multidisciplinary team: an ethnographic study of four head and neck cancer centres in the north of England

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Authors

DHDavid W. HamiltonBHBenjamin HeavenRTRichard Thomson

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Overview

Ethnographic study uncovers barriers to shared decision-making in head and neck cancer care, suggesting rigid multidisciplinary recommendations reinforce a cycle of paternalism.

Key Points

  • To evaluate how patients participate in treatment decisions within multidisciplinary team (MDT) settings and investigate how clinical recommendations affect shared decision-making.
  • Qualitative ethnographic study conducted across four head and neck cancer centres in northern England.
  • Included non-participant observation of 35 MDT meetings and 37 clinics, field notes, informal interviews, and formal semistructured interviews with 20 patients and 9 MDT staff members.
  • MDT discussions routinely generated a single, firm treatment recommendation that patients often accepted due to feelings of disempowerment during consultations.
  • Patient compliance was misread by clinicians as a preference for paternalistic care, creating a feedback loop that prevented the exploration of alternative treatment options and individual values.

Cite This Study

Hamilton et al. (2022) studied this question.

synapsesocial.com/papers/6a710ec7660549caf2c5b160https://doi.org/10.1136/bmjopen-2022-061654
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Also Consider

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  4. 4Decision Coaching to Support Shared Decision Making: A Framework, Evidence, and Implications for Nursing Practice, Education, and Policy2008 · 193 citations
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