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Decision making in the management of adults with malignant colorectal polyps: An exploration of the experiences of patients and clinicians
Author(s) -
Westwood Clare,
Lee Tom,
McSherry Robert,
BettanySaltikov Josette,
Catlow Jamie
Publication year - 2021
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15743
Subject(s) - medicine , context (archaeology) , interpretative phenomenological analysis , qualitative research , colorectal cancer , dilemma , family medicine , cancer , paleontology , social science , philosophy , epistemology , sociology , biology
Aim A diagnosis of colorectal polyp cancer presents a treatment dilemma. The decision between segmental resection versus endoscopic surveillance is difficult due to a lack of good quality clinical evidence for either option. The aim of this study was to understand the decision making experiences of both clinicians and patients when faced with such a diagnosis. Methods Qualitative, semi‐structured interviews were undertaken with 10 clinicians involved in the care of patients diagnosed with polyp cancer and five patients who had experience of a diagnosis of polyp cancer. All clinicians and patients were from four hospital trusts across the north of England. Interviews were audio‐recorded, transcribed verbatim and analysed using the principles of interpretative phenomenological analysis. Results Analysis of the interview transcripts evidenced that clinicians and patients were supportive of a shared approach to treatment decision making in the context of a diagnosis of colorectal polyp cancer. Uncertainty, influences and information were among the themes identified to be preventing this happening at present. This study identified themes which were common to both groups. These were complexity of the risk information, lack of patient information resources, and system factors and time. Conclusion This research study has evidenced several factors such as uncertainty, complexity of risk information and influences on decisions which are preventing patients being involved in treatment decisions following a diagnosis of colorectal polyp cancer. Recommendations for improvements in practice, including a framework to assist treatment decision making in the future, are highlighted.