Decision making in the management of adults with malignant colorectal polyps: An exploration of the experiences of patients and clinicians.
malignant colorectal polyps
patient-centred care
polyp cancer
treatment decision-making
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
11
04
2021
received:
19
12
2020
accepted:
12
04
2021
pubmed:
20
5
2021
medline:
16
9
2021
entrez:
19
5
2021
Statut:
ppublish
Résumé
A diagnosis of colorectal polyp cancer presents a treatment dilemma. The decision between segmental resection versus endoscopic surveillance is difficult due to a lack of good quality clinical evidence for either option. The aim of this study was to understand the decision making experiences of both clinicians and patients when faced with such a diagnosis. Qualitative, semi-structured interviews were undertaken with 10 clinicians involved in the care of patients diagnosed with polyp cancer and five patients who had experience of a diagnosis of polyp cancer. All clinicians and patients were from four hospital trusts across the north of England. Interviews were audio-recorded, transcribed verbatim and analysed using the principles of interpretative phenomenological analysis. Analysis of the interview transcripts evidenced that clinicians and patients were supportive of a shared approach to treatment decision making in the context of a diagnosis of colorectal polyp cancer. Uncertainty, influences and information were among the themes identified to be preventing this happening at present. This study identified themes which were common to both groups. These were complexity of the risk information, lack of patient information resources, and system factors and time. This research study has evidenced several factors such as uncertainty, complexity of risk information and influences on decisions which are preventing patients being involved in treatment decisions following a diagnosis of colorectal polyp cancer. Recommendations for improvements in practice, including a framework to assist treatment decision making in the future, are highlighted.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2052-2061Informations de copyright
© 2021 The Association of Coloproctology of Great Britain and Ireland.
Références
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