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191 Shared decision making (SDM) with ethnic minorities in oncology: a qualitative study mapping the value structure underlying the experiences of patients, relatives and healthcare professionals in SDM
  1. Roukayya Oueslati1,2,
  2. Asiye Gedik3,
  3. Ria Reis4,
  4. Yvonne Van Zaalen5,
  5. Meralda T Slager6,
  6. Barbara Schouten7,
  7. Anne M Stiggelbout8,9,
  8. Dorothea P Touwen1
  1. 1Department of Ethics and Law of Health Care, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Nursing, The Hague University of Applied Sciences, The Hague, The Netherlands
  3. 3Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands
  4. 4Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
  5. 5Research Group Relational Care, The Hague University of Applied Sciences, The Hague, The Netherlands
  6. 6Centre of Expertise Perspective in Health, Avans University of Applied Sciences, The Netherlands
  7. 7Department of Communication Science, Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
  8. 8Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
  9. 9Erasmus School of Health Policy and Management, Erasmus University Rotterdam, The Netherlands


Introduction Ethnic minorities in the Netherlands are expected to increasingly use oncological care. In this care setting many treatment decisions are appropriate for shared decision making (SDM). However, limited research is available on ethnic minority patients’ experiences with SDM in oncology. Therefore, the aim of the current study was to map the values that underlie the perspectives on and experiences with SDM of patients with cancer and their relatives with a Moroccan, Turkish, or Surinamese Hindustani background, and those of healthcare professionals (HCPs).

Methods We interviewed patients (n=22) diagnosed with various types of cancer in different stages of their treatment trajectory, relatives (n=11), and HCPs (n=14). During the interviews with patients and relatives timelines of the treatment trajectory were drawn. Currently, we are analyzing the data using reflexive thematic analysis (TA) through the lens of Schwartz’s value theory. We identify Schwartz values in the data and define them for the actors involved in SDM. We will analyze the relationship between the values and develop themes based on these value-relations.

Results We already identified eight of Schwartz’s values with their definitions for the SDM context: Achievement (knowledge, competencies, skills), Benevolence (support, wellbeing), Conformity (to another person, restrictions in treatment selection), Power (of HCP, patient, relative), Security (good relationship, trust), Self-Direction (autonomy, participation), Tradition (culture, religion, alternative medicine), Universalism (equality, deliberation, tailoring).

Discussion By mapping the underlying values of patients and relatives and those of HCPs we are able to compare their values and detect opportunities for SDM’s adaptation to the needs of ethnic minorities.

Conclusion(s) The value structures we will develop can contribute to the incorporation of the values of ethnic minorities into SDM and make SDM more inclusive.

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