Introduction:
In Japan, shared decision-making is becoming increasingly important in clinical practice. This process is particularly complex in elderly patients, especially when cognitive decline such as dementia is involved. Such cases can place a significant burden on attending physicians and may impede optimal patient care.
Objective:
The aim of this study was to identify the factors that contribute to difficulties by physicians in providing decision-making support to elderly patients.
Method:
A questionnaire survey was conducted among 38 physicians engaged in cancer treatment at Hospital A. The study received approval from the hospital’s ethics review board and was conducted anonymously to protect participant privacy.
Results:23 out of 38 (60.5%) responded. Fourteen (60.8%) doctors were “very much affected” by “patients with apparent dementia” as a factor that makes it difficult to provide decision-making support in making treatment decisions for elderly cancer patients, a higher proportion than for other factors. On the other hand, only 5 (21.7%) answered “very much affected” for “mild cognitive impairment” and 7 (30.4%) for “mental problems such as depression and sleep disorders”.
Conclusion:
Physicians treating elderly cancer patients perceive dementia as a particularly significant challenge in the decision-making process. These findings suggest the need to enhance support systems through multidisciplinary collaboration. In particular, promoting educational programs that improve co-medical staff’s understanding and practical competencies in dementia care may help alleviate the burden on physicians. Further research should explore whether similar trends exist in other medical specialties other than cancer care.
Keywords:
Dementia, Decision-making support, Elderly patients, Cancer care.
