Olvement, although low-acculturated Latina womenDecember 2013, Vol 103, No. 12 | American Journal of Public

Olvement, although low-acculturated Latina womenDecember 2013, Vol 103, No. 12 | American Journal of Public HealthMead et al. | Peer Reviewed | Systematic Review | eSYSTEMATIC REVIEWTABLE 1–Characteristics of Articles Included in a Systematic Literature Review on Shared Decision-Making in Cancer Treatment Among Minority PopulationsCharacteristic Cancer site Breast Prostate Lung Multiple Not reported Study location United States Outside United States Study populationa Patients Patients’ family and others Health PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19890070 care providers Minority race/ethnicity of study populationa African American Latina/Latino Asian Haredi Ashkenazi Jewish Non-Hispanic White Other (not specified) Level of decision-makinga Patient Family and others CommunityaQuantitative Studies (n = 11), No. ( )Qualitative Studies (n = 12), No. ( )8 (73) 1 (9) 0 2 (18) 0 10 (91) 1 (9) 11 (100) 0 1 (9) 9 (82) 6 (55) 1 (9) 0 9 (82) 3 (27) 11 (100) 5 (45)9 (75) 1 (8) 1 (8) 0 1 (8) 9 (75) 3 (25) 11 (92) 3 (25) 3 (25) 5 (42) 3 (25) 4 (33) 1 (8) 3 (25) 1 (8) 12 (100) 8 (67) 1 (8)Some studies had more than 1 subcategory.were more likely to report too little involvement. Women whose decision-making role matched their preferences had the highest satisfaction with treatment received, the highest satisfaction with decision-making process, and the lowest decisional regret. By GSK126 contrast, women whose decisionmaking role was less or more than they preferred were at increased risk of treatment MedChemExpress ARRY-162 dissatisfaction (OR range = 1.5—2.6; P < .005), decision-making process dissatisfaction (OR range = 2.5---3.2; P < .001), and high decisional regret (OR range =1.7---2.4; P < .001).31 Qualitative studies indicated cultural variation in the adoptionof different decision-making models and offered some explanatory insights (Table 4). Highacculturated Asian American women preferred a more active decisional role, believing that active engagement was necessary to ensure that the provider presented all treatment options.36 A study of low-acculturated Punjabi women reported low decisional involvement, insufficient information about treatments, and a lack of full engagement in the decisionmaking process.39 Many (though not all) low-acculturated Chinese and Korean American cancer patients preferred a providerbased decision-making model.Another study concurred that Chinese American women reported discomfort with the multiple treatment options presented. They felt it indicated a lack of authority and expertise and they tried to interpret the "real" recommendation.41 Although 1 study found that the majority of Latina and African American cancer patients preferred a significant amount of provider involvement in decision-making, overall, these populations reported feeling disempowered in the decisionmaking process.42,43,45,46 They expressed the need for more information, empowerment to selfadvocate, and physicians' respect for patients' autonomy. In a study of Haredi Ashkenazi Jewish women, respondents reported that, although they preferred a rabbi-as-agent model similar to the provider-based decision-making model, they struggled with the consequences and benefits of delegating their decision to an authority figure.38 One study of African American women with breast cancer found that lack of participation in decision-making led many of them to reject chemotherapy.43 Thus, the sense of disempowerment from poorly aligned decision-making preferences and roles could sometimes result in nonadherence to cancer treatment.Patien.Olvement, although low-acculturated Latina womenDecember 2013, Vol 103, No. 12 | American Journal of Public HealthMead et al. | Peer Reviewed | Systematic Review | eSYSTEMATIC REVIEWTABLE 1--Characteristics of Articles Included in a Systematic Literature Review on Shared Decision-Making in Cancer Treatment Among Minority PopulationsCharacteristic Cancer site Breast Prostate Lung Multiple Not reported Study location United States Outside United States Study populationa Patients Patients' family and others Health PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19890070 care providers Minority race/ethnicity of study populationa African American Latina/Latino Asian Haredi Ashkenazi Jewish Non-Hispanic White Other (not specified) Level of decision-makinga Patient Family and others CommunityaQuantitative Studies (n = 11), No. ( )Qualitative Studies (n = 12), No. ( )8 (73) 1 (9) 0 2 (18) 0 10 (91) 1 (9) 11 (100) 0 1 (9) 9 (82) 6 (55) 1 (9) 0 9 (82) 3 (27) 11 (100) 5 (45)9 (75) 1 (8) 1 (8) 0 1 (8) 9 (75) 3 (25) 11 (92) 3 (25) 3 (25) 5 (42) 3 (25) 4 (33) 1 (8) 3 (25) 1 (8) 12 (100) 8 (67) 1 (8)Some studies had more than 1 subcategory.were more likely to report too little involvement. Women whose decision-making role matched their preferences had the highest satisfaction with treatment received, the highest satisfaction with decision-making process, and the lowest decisional regret. By contrast, women whose decisionmaking role was less or more than they preferred were at increased risk of treatment dissatisfaction (OR range = 1.5—2.6; P < .005), decision-making process dissatisfaction (OR range = 2.5---3.2; P < .001), and high decisional regret (OR range =1.7---2.4; P < .001).31 Qualitative studies indicated cultural variation in the adoptionof different decision-making models and offered some explanatory insights (Table 4). Highacculturated Asian American women preferred a more active decisional role, believing that active engagement was necessary to ensure that the provider presented all treatment options.36 A study of low-acculturated Punjabi women reported low decisional involvement, insufficient information about treatments, and a lack of full engagement in the decisionmaking process.39 Many (though not all) low-acculturated Chinese and Korean American cancer patients preferred a providerbased decision-making model.Another study concurred that Chinese American women reported discomfort with the multiple treatment options presented. They felt it indicated a lack of authority and expertise and they tried to interpret the "real" recommendation.41 Although 1 study found that the majority of Latina and African American cancer patients preferred a significant amount of provider involvement in decision-making, overall, these populations reported feeling disempowered in the decisionmaking process.42,43,45,46 They expressed the need for more information, empowerment to selfadvocate, and physicians' respect for patients' autonomy. In a study of Haredi Ashkenazi Jewish women, respondents reported that, although they preferred a rabbi-as-agent model similar to the provider-based decision-making model, they struggled with the consequences and benefits of delegating their decision to an authority figure.38 One study of African American women with breast cancer found that lack of participation in decision-making led many of them to reject chemotherapy.43 Thus, the sense of disempowerment from poorly aligned decision-making preferences and roles could sometimes result in nonadherence to cancer treatment.Patien.