ArticleHealth expectations : an international journal of public participation in health care and health policy2022
Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country.
Article in Health expectations : an international journal of public participation in health care and health policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Key challenges in communication across milestones of cancer care continuum: a systematic review.BMC palliative care · 2026Pooled it
- Barriers and facilitators to shared decision-making for patients with cancer and health care providers based on the COM-B model: a systematic review.BMC medical informatics and decision making · 2025Pooled it
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- Beyond the Cure: Unveiling the Silent Struggles of Breast Cancer Survivors in Hong Kong.Healthcare (Basel, Switzerland) · 2026Article
- Understanding, Recognizing, and Managing Cancer-Related Fatigue Associated with Breast Cancer.Current treatment options in oncology · 2026Review
- Barriers and facilitators of implementing patient-reported outcome measures in clinical care using the CFIR-ERIC framework.Scientific reports · 2026Article
- Chinese people's experience of cancer in the UK: a reflexive thematic analysis.Frontiers in psychology · 2026Article
- Knowledge Translation Initiative to Improve Interdisciplinary Approaches to Psychosocial Oncology Among Community Stakeholders in Rural Regions of British Columbia.International journal of environmental research and public health · 2025Article
- Shared decision-making in urinary reconstruction among radical cystectomy patients: a thematic analysis of patient and provider perspectives in China.BMC cancer · 2025Article
- From Burden to Empowerment. Patient-Reported Influencing Factors on Participation in Shared Decision Making in Oncology, a Meta-Study.Psycho-oncology · 2025Review
- Support and care needs among Mexican women with metastatic breast cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Perspectives of clinicians on shared decision making in hospice care for advanced cancer patients in Nanjing: a descriptive qualitative study.BMC palliative care · 2025Article
- Underserved Patient Populations With Metastatic Breast Cancer: A Review of Progress and Remaining Challenges.The breast journal · 2025Review
- Towards Agility in Breast Cancer Treatment Principles as Adopted from Agile Software Engineering.Journal of multidisciplinary healthcare · 2024Article
- Implications of Agile Values in Software Engineering for Agility in Breast Cancer Treatment: Protocol for a Comparative Study.JMIR research protocols · 2023Article
- Barriers of and strategies for shared decision-making implementation in the care of metastatic breast cancer: A qualitative study among patients and healthcare professionals in an Asian country.Health expectations : an international journal of public participation in health care and health policy · 2022Article
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShared decision-making has been shown to improve the quality of life in metastatic breast cancer patients in high-literacy and high-resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision-making implementation and the barriers encountered in an Asian setting where societal norms predominate and physician decision-making is at the forefront. This paper aims to identify (1) barriers to practising shared decision-making faced by healthcare professionals and patients and (2) strategies for implementing shared decision-making in the context of metastatic breast cancer management in Malaysia.
methodsWe conducted a qualitative study involving 12 patients diagnosed with metastatic breast cancer, 16 healthcare professionals and 5 policymakers from surgical and oncology departments at public healthcare centres in Malaysia. Semi-structured in-depth interviews and focus group discussions were conducted. The interviews were recorded, transcribed verbatim and analysed using the thematic approach. Nvivo software was used to manage and analyse the data.
resultsFive main themes emerged from the study: healthcare provider-patient communication, workforce availability, cultural and belief systems, goals of care and paternalism versus autonomy. Other strategies proposed to overcome barriers to implementing shared decision-making were training of healthcare professionals and empowering nurses to manage patients' psychosocial issues.
conclusionThis study found that practising shared decision-making in the public health sector remains challenging when managing patients with metastatic breast cancer. The utilization of decision-making tools, patient empowerment and healthcare provider training may help address the system and healthcare provider-patient barriers identified in this study. PATIENT OR PUBLIC CONTRIBUTION: Patients were involved in the study design, recruitment and analysis.
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