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Treatment decisions in advanced prostate cancer. Organizational factors affecting patient involvement

Mette Løwe Netsey-Afedo, Jette Ammentorp, Palle Jörn Sloth Osther, Regner Birkelund


Background, Aims and Objectives: Many healthcare systems have undergone organizational or structural changes to improve productivity and efficiency. Simultaneously, political requirements are urging both standardized pathways in cancer treatment, person-centered care and shared decision-making. These changes and requirements have created changed conditions for patient involvement.

Methods: In this article, we explore how and in which organizational framework decisions were made concerning the treatment of men with advanced prostate cancer. Moreover, we explored how health professionals and patients perceive the influence of the organizational framework on the decision-making process. Additionally, participant observations of patient consultations and the environment in an outpatient clinic, as well as qualitative interviews with patients and health professionals, were conducted.

Results and Discussion: The findings revealed that tight schedules, short consultations, and the lack of continuity in a patient’s treatment, caused poor conditions for sufficient dialogue between patients and health professionals and, thus, poor conditions for patient involvement.


Advanced prostate cancer, cancer pathways, communication, decision-making, dialogue, goals, organizational factors, participant observation, patient expectations, patient experience, patient involvement, patient-physician relationship, priorities, qualita

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