Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Shared decision-making, decisional conflict, and decisional regret among Indian cancer patients from lower socioeconomic backgrounds (125813)

Dr. Tahreen Syed 1 , Dr. Megha Deuskar 2 , Dr. Girish Lad 3
  1. Director and Head,-Psychooncology, Rising India Research Foundation, Pune, maharashtra, India
  2. Assistant Professor, Department of Psychology, Fergusson College (Autonomous), , Pune, maharashtra, India
  3. Founder Chairman, Texas School of Mental Health, USA, USA

Objectives: Shared Decision-Making (SDM) has emerged as a cornerstone of patient-centred care, especially in oncology and has been proven to directly influence treatment adherence and outcomes. However, despite its clinical importance, SDM is not uniformly implemented across patient populations, and disparities may exist based on socioeconomic status (SES). This study aimed to investigate the extent and quality of SDM among cancer patients from lower SES backgrounds and its relationship with decisional conflict, self-efficacy, and decisional regret.

Sample and setting: Data was collected from 114 cancer patients (71 females, 42 males and 1 unstated gender), having varied types of cancers. All of them were outpatients of Indrayani Hospital, Alandi, Maharashtra and hailed from lower socio-economic background.

Procedures: Standardized tools including the Shared Decision-Making Questionnaire (SDMQ), the Decisional Regret Scale (DRS), and the Decision Self-Efficacy Scale (DSES), and a personal data sheet were administered to consenting patients.

Results: While DSES was found to be significantly positively correlated with SDM (Spearman’s rho=0.724, p< .01) and SDM in turn was  significantly negatively correlated with DRS (Spearman’s rho = -0.375, p<.01) as expected, there were some concerning findings. Over 30% of the patients reported not being included in Shared Decision Making, and an equal number reported not having the confidence in their own ability to understand, evaluate or decide from the treatment options available. SDM was also negatively correlated with age and positively with level of education.

Clinical implications: These findings highlight two peculiar challenges in the implementation of SDM: one, the communication gap between patients and healthcare providers and two, the lack of motivation to have an agency in the decision-making process among disadvantaged cancer patients.

Keywords: Shared decision making, Decisional Conflict, Decisional Regret, Decisional Self-efficacy, Cancer, Lower Socio-economic class