Shared Decision Making Among Individuals With Cancer in Non-Western Cultures: A Literature Review

Purpose/Objectives: To examine the extent to which shared decision making is a concept addressed within the published, empirical oncology decision-making research originating from non-Western countries from January 2000 to January2012 and provide an overview of the outcomes of this research.

Data Sources: MEDLINE®, CINAHL®, Google Scholar, PsycINFO, Web of Science, and PubMed were searched for oncology decision-making literature published in English from January 2000 to January 2012.

Data Synthesis: Charles's three-stage conceptual framework of shared decision making was used as an organizational framework for the 26 articles meeting the initial criteria and reporting on at least one decision-making stage.

Conclusions: Although most patients wanted to be informed of their diagnosis, patient preferences for information and participation in decision making differed from that of physicians and varied among and within cultures. Few studies in this review addressed all three stages of shared decision making. Physician and patient attitudes, preferences, and facilitators and barriers to potential successful adoption of shared decision making in non-Western cultures require additional study.

Implications for Nursing: Nurses should assess patients from non-Western countries regarding their knowledge of and desire to participate in shared decision making and provide decision support as needed.

Knowledge Translation: Shared decision making may be new to patients from non-Western cultures, necessitating assessment, education, and support. Non-Western patients may value having family and friends accompany them when a cancer diagnosis is given, but assumptions based on culture alone should not be made. Nurses should determine patient preferences for diagnosis disclosure, information, and participation in decision making.