Female cancer patients’ awareness and role in family-based medical decision making mode in Confucian area.

Abstract

237 Background: Medical decision making of Chinese patients was family based, especially for female cancer patients. However, few studies have systematically investigated female patients. We aimed to illustrate the determinant of female cancer patients’ role in decision making. Methods: A total of 286 adult female cancer patients were included in this study between September 1st 2013 and December 31st 2013 from 13 leading general hospitals across China. A questionnaire was given to the oncologists in charge to evaluate each patient concerning the interaction between family and cancer patients, patients’ awareness of disease and participation in medical decision making in mainland China. In this study, the family statuses of patients were ranked as superordinate (one who was the major decision maker in family), equality (one discussed important issues with family members and made decision with consensus of family members), and subordinate (those who usually don’t be involved in significant family issues). Results: Among the 286 cancer patients, only 29 (10.1%) patients made decision themselves. 221 (77.3%) patients delegated decision making to their family. The rest of 36 (12.6%) patients were involved in decision making. Patients with nonlocal insurance, which meant they traveled to the major cities for advanced medication, were inclined to let their family members make decision for them. Patients’ family status significantly determined their participation in medical decision making. Female patients as superordinate family members (4.5%), tend to play a positive role in medical decision. By contrast, patients with subordinate role in family (66.4%) persistantly play a passive role in medical decision making. Violation of medical recommendation increased according to the severity of patients’ prognosis. Cancer progression (90.6%), financial expense (65.7%) and life expectancy (94.1%) was always hidden from female patients by their families, especially for those with incurable disease. Conclusions: Medical decision making of female Chinese cancer patients was mainly family based. Female patients’ awareness of disease and participation in medical decision making was still needs improvement.