Patients' Attitudes Towards Integrating Environmental Sustainability Into Healthcare Decision-Making: An Interview Study.

Introduction: The ethical obligation to reduce the environmental impact of healthcare systems prompts an exploration of if and when environmental concerns should be integrated into clinical decision-making. In this study, we aimed to elucidate patients' attitudes regarding the provision of environmental information in healthcare decision-making and to identify preferred approaches for integrating these considerations into patient-provider consultations.

Methods: This interview study served as an in-depth follow-up of a survey study on gynaecological patients' perspectives on environmental sustainability within healthcare settings.

Impact of the Number of Positive Pelvic Lymph Nodes on Risk of Para-Aortic Recurrence in Patients with Clinically Early Cervical Cancer Treated by a Radical Hysterectomy and Pelvic Lymphadenectomy.

Background: Guidelines recommend the extension of the pelvic radiotherapy volume to the para-aortic region in locally advanced cervical cancer and ≥3 suspicious pelvic lymph nodes (PLN) on imaging. Whether this recommendation is also valid for clinically early stages is uncertain. The objective of this study was to investigate the para-aortic (PAO) lymph node recurrence rate in patients with early-stage cervical cancer, ≥3 metastatic PLN, and negative common iliac nodes after a radical hysterectomy followed by pelvic (chemo)radiotherapy without extension to the PAO region.

Decision-Making Interventions for Pelvic Organ Prolapse: A Systematic Review, Meta-Analysis, and Environmental Scan.

People diagnosed with pelvic organ prolapse (POP) face preference-sensitive treatment decisions. We conducted a systematic review, meta-analysis, and narrative synthesis to determine the effect of decision-making interventions for prolapse on patient-reported outcomes. To gain a more complete understanding of all potentially accessed resources, we also conducted an environmental scan to determine the quantity and quality of online interventions for prolapse decision-making.

The UPFRONT project: tailored implementation and evaluation of a patient decision aid to support shared decision-making about management of symptomatic uterine fibroids.

Objective: To evaluate implementation of a patient decision aid for symptomatic uterine fibroid management to improve shared decision-making at five clinical settings across the United States.

Methods: We used a type 3 hybrid effectiveness-implementation stepped-wedge design and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) planning and evaluation framework. We conducted clinician training, monthly reach tracking with feedback to site clinical leads, patient and clinician surveys, and visit audio-recordings.

Exploring the MAPPING application to facilitate risk communication and shared decision-making between physicians and patients with gynaecological cancer.

This is an observational study in which we evaluated current levels of risk communication (RC) among gynaecological oncologists and their view on the Mapping All Patient Probabilities in Numerical Graphs (MAPPING) application as a possible tool to facilitate RC and shared decision-making (SDM). In part A, we audio-recorded 29 conversations between gynaecological oncologists and patients when discussing treatment options. In part B, interviews were performed with eight gynaecological oncologists.

Patients' preferences, experiences and expectations with wait time until surgery in gynaecological oncology: a mixed-methods study in two gynaecological oncological centres in the Netherlands.

Objectives: Patient-centredness of care during wait time before surgery can be improved. In this study we aimed to assess (1) patients' experiences with and preferences regarding wait time before surgery; (2) the impact of wait time on quality of life (QoL) and (3) which factors influence patients' wait time experience.

Design, Setting, Participants: We performed an exploratory sequential mixed-methods study among women with gynaecological cancer in two tertiary hospitals.

Unravelling clinicians' shared decision-making adoption: a qualitative exploration through the lens of diffusion of innovations theory.

Objectives: This study uses the diffusion of innovations (DOI) theory to comprehensively understand the adoption of shared decision-making (SDM) in clinical practice, specifically focusing on the 'knowledge' and 'persuasion' stages within DOI. We aim to understand the challenges and dynamics associated with SDM adoption, offering insights for more patient-centred decision-making in healthcare.

Design: This qualitative study employs a modified framework analysis approach, integrating ethnographic and interview data from prior research, along with additional interviews.

Preferences and considerations for interval cytoreductive surgery in advanced ovarian cancer: The patient's perspective.

Objective: Treatment of advanced-stage ovarian cancer contains cytoreductive surgery (CRS) and chemotherapy. Achieving successful CRS (≤ 1 cm residual disease) is prognostically important, but may not be feasible peri-operatively while still risking complications. Therefore, patients' treatment expectations are important to discuss.

Explorative observational study of Dutch patient-clinician interactions: operationalisation of personal perspective elicitation as part of shared decision-making in real-life audio-recorded consultations.

Objectives: Patients' preferences, values and contexts are important elements of the shared decision-making (SDM) process. We captured those elements into the concept of 'personal perspective elicitation' (PPE), which reflects the need to elicit patients' preferences, values and contexts in patient-clinician conversations. We defined PPE as: 'the disclosure (either elicited by the clinician or spontaneously expressed by the patient) of information related to the patient's personal preferences, values and/or contexts potentially relevant to decision-making'.

Patient-reported outcome measures (PROMs) to personalise follow-up care of ovarian cancer: what do patients think? A qualitative interview study.

Purpose: The purpose of this study was to explore ovarian cancer patients' preferences regarding follow-up care and, in particular, the use of patient-reported outcome measures (PROMs) as an approach to personalise follow-up care.

Methods: Between May and June 2021, semi-structured interviews were conducted with ovarian cancer patients, who had finished their primary treatment at least 6 months prior and were receiving follow-up care at our centre. Interviews were transcribed verbatim and analysed using an inductive thematic approach.

Assessing the educational quality of shared decision-making interventions for residents: A systematic review.

Objectives: Many studies on educational interventions to enhance residents' shared decision-making (SDM) skills show limited improvement in SDM skills and clinical outcomes. One plausible explanation for these suboptimal results is the insufficient emphasis on the educational quality of training interventions.

Methods: This review evaluates interventions' educational quality using an evaluation framework based on a previous study on effective skills transfer and a well-known SDM model.

Disentangling trust of patients with rare cancer in their healthcare professionals and the healthcare system: a qualitative interview study.

Purpose: Patients with a rare cancer face challenges, e.g., delayed diagnosis, that may affect trust in the healthcare system and the healthcare professionals (HCPs) involved.

Can late lymphoscintigraphy be omitted in the sentinel node procedure in early-stage vulvar cancer?

Introduction: In the Netherlands, the sentinel lymph node procedure protocol consists of preoperative lymphoscintigraphy combined with intraoperative blue dye for identifying sentinel lymph nodes in early vulvar squamous cell carcinoma. This study aimed at investigating the role of early and late lymphoscintigraphy.

Material And Methods: From January 2015 to January 2019, early and late lymphoscintigraphies of 52 women were retrospectively analyzed.

Bringing personal perspective elicitation to the heart of shared decision-making: A scoping review.

Objectives: Proponents of shared decision-making (SDM) advocate the elicitation of the patient's perspective. This scoping review explores if, and to what extent, the personal perspectives of patients are elicited during a clinical encounter, as part of a SDM process. We define personal perspective elicitation (PPE) as: the disclosure (either elicited by the clinician or spontaneously expressed by the patient) of information related to the patient's personal preferences, values and/or context.

Development of an adjective-selection measure evaluating clinicians' attitudes towards using patient decision aids: The ADOPT measure.

Background: The implementation of shared decision-making and patient decision aids (PDAs) is impeded by clinicians' attitudes.

Objective: To develop a measure of clinician attitude towards PDAs.

Methods: To develop the ADOPT measure, we used four stages, culminating in measure responses by medically qualified clinicians, 25 from each of the following specialties: emergency medicine, family medicine, oncology, obstetrics and gynaecology, orthopaedics, and psychiatry.

Comparison of the CollaboRATE and SDM-Q-9 questionnaires to appreciate the patient-reported level of shared decision-making.

Objective: To compare CollaboRATE and SDM-Q-9 questionnaires when appreciating patient-perceived level of shared decision-making (SDM) in doctor-patient consultations.

Methods: Data were harvested from five separate studies on SDM, conducted in three university and one large community hospital in the Netherlands, using Dutch versions of both questionnaires. CollaboRATE and SDM-Q-9 scores were expressed as percentages.

The Tell me tool: The development and feasibility of a tool for person-centred infertility care.

Background: An important-and often missing-element of person-centred care is the inclusion of individual patients' values and preferences. This is challenging but especially important for high-burden fertility treatments. We describe the development of a clinical tool that aims to facilitate the delivery of person-centred fertility care by giving insight into the patients' values and preferences.

Structurally collecting patient feedback on trainee skills: A pilot study in Obstetrics and Gynaecology.

Objective: This pilot study tested a tool that collects patient feedback on trainees' skills in shared decision-making (SDM) and general consultation. It also examined trainees' views on SDM and patient feedback, exploring potential skills improvement through reflexive practice.

Methods: Patients were asked to rate trainees after consultation in a six-itemed questionnaire.