Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal... Show moreSexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training. Show less
PurposeThe original 18-item, four-dimensional Trust in Oncologist Scale assesses cancer patients’ trust in their oncologist. The current aim was to develop and validate a short form version of the... Show morePurposeThe original 18-item, four-dimensional Trust in Oncologist Scale assesses cancer patients’ trust in their oncologist. The current aim was to develop and validate a short form version of the scale to enable more efficient assessment of cancer patients’ trust.MethodsExisting validation data of the full-length Trust in Oncologist Scale were used to create a short form of the Trust in Oncologist Scale. The resulting short form was validated in a new sample of cancer patients (n = 92). Socio-demographics, medical characteristics, trust in the oncologist, satisfaction with communication, trust in healthcare, willingness to recommend the oncologist to others and to contact the oncologist in case of questions were assessed. Internal consistency, reliability, convergent and structural validity were tested.ResultsThe five-item Trust in Oncologist Scale Short Form was created by selecting the statistically best performing item from each dimension of the original scale, to ensure content validity. Mean trust in the oncologist was high in the validation sample (response rate 86%, M = 4.30, SD = 0.98). Exploratory factor analyses supported one-dimensionality of the short form. Internal consistency was high, and temporal stability was moderate. Initial convergent validity was suggested by moderate correlations between trust scores with associated constructs.ConclusionsThe Trust in Oncologist Scale Short Form appears to efficiently, reliably and validly measures cancer patients’ trust in their oncologist. It may be used in research and as a quality indicator in clinical practice. More thorough validation of the scale is recommended to confirm this initial evidence of its validity. Show less
Kunneman- van Unnik, Helena Josefina Antonia Maria 2016
In this thesis, we aimed to gain insight in the process of shared decision making in the setting of adjuvant cancer treatments. We observed clinician-patient consultations in daily clinical... Show moreIn this thesis, we aimed to gain insight in the process of shared decision making in the setting of adjuvant cancer treatments. We observed clinician-patient consultations in daily clinical practice, and developed a core list of information that should be provided in the pre-treatment consultation. We showed that the three key steps of shared decision making are followed to a limited extent. Choice awareness is rarely created in pre-treatment consultations on (neo-)adjuvant cancer treatment, and the option of foregoing these treatments is omitted consistently (Step 1). There is large variation in information provision on possible treatment strategies. Patients tend to overestimate the beneficial effect of treatment, and to underestimate the probability of harms (Step 2). Finally, patients' values and treatment preferences are elicited in only a minority of consultations. If patients voice their values or treatment preferences, or if the oncologist indicates to consider these, patients perceive a significant more active role in the decision making process (Step 3). Our results show that opportunities are missed to engage patients in a process of shared decision making. Small changes in doctor-patient communication can facilitate patients' involvement in deciding about treatment. Show less
