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Older Adults Newly Diagnosed With Symptomatic Myeloma and Treatment Decision Making

Joseph D. Tariman
Ardith Doorenbos
Karen G. Schepp
Seema Singhal
Donna L. Berry
ONF 2014, 41(4), 411-419 DOI: 10.1188/14.ONF.411-419

Purpose/Objectives: To describe the preferences for participation in decision making of older adult patients newly diagnosed with symptomatic myeloma and to explore the association between sociodemographic variables and decisional role preferences.

Design: Descriptive, cross-sectional design.

Setting: Participants' homes and two large academic cancer centers in Seattle, WA, and Chicago, IL.

Sample: A convenience sample of 20 older adults (60 years of age and older) with symptomatic myeloma diagnosed within the past six months.

Methods: The Control Preferences Scale was administered followed by an in-person, one-time, semistructured interview.

Main Research Variables: Role preferences for participation in treatment decision making, age, gender, race, work status, personal relationship status, education, and income.

Findings: Fifty-five percent of the participants preferred a shared role with the physician and 40% preferred to make the decisions after seriously considering the opinion of their physicians. Only one participant preferred to leave the decision to the doctor, as long as the doctor considered the patient's treatment preferences.

Conclusions: The study findings indicate that older adults newly diagnosed with myeloma want to participate in treatment decision making. Oncology nurses must respect the patient's desired role preference and oncology clinicians must listen to the patient and allow him or her to be autonomous in making treatment decisions.

Implications for Nursing: Nurses and other oncology clinicians can elicit a patient's preferred level of participation in treatment decision making. Oncology nurses can make sure patients receive disease- and treatment-related information, encourage them to express their decisional role preference to the physician, develop a culture of mutual respect and value their desire for autonomy for treatment decision making, acknowledge that the right to make a treatment choice belongs to the patient, and provide support during treatment decision making throughout the care continuum.

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