Shared decision-making in cervical cancer care patients at Tikur Anbessa specialized Hospital, Addis Ababa, Ethiopia
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Date
2025-06
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Addis Ababa University
Abstract
Background: Shared decision-making is crucial for alignment of treatment options with patient
values and preferences in clinical cancer care due to the complexity of treatment options and the
significant impact of decisions on patients' lives. However, currently in Ethiopia, shared decisionmaking
in clinical care of cancer, in which cervical cancer is not exceptional, is not well
understood.
Objectives: To determine the level of shared decision-making in the clinical care of women with
cervical cancer and its associated factors.
Methods: The study employed a convergent mixed study design from February to June 2025 at
Tikur Anbessa Specialized Hospital. Quantitative data were collected through intervieweradministered
questionnaires from 203 women undergoing treatment for cervical cancer.
Additionally, qualitative data were gathered through in-depth interviews with 15 women with
cervical cancer on follow-up, as well as 10 clinical oncologists who have provided care for these
patients for the past three years. Statistical analysis was executed using software SPSS (version
26). Descriptive statistics were employed to summarize the variables of the study. Multiple linear
regression analysis was then carried out to determine significant predictors of level of shared
decision-making. Thematic analysis was conducted for the qualitative findings. Quantitative and
qualitative findings were integrated to explain factors predicted the level of shared decisionmaking
in the clinical care of women with cervical cancer.
Result: With a ranging scale of 16–53 and a standardized mean score of 3.78 (± 0.54), the overall
mean score for the current study's level of shared decision-making was 33.94 (± 9.11). According
to this study, there are significant positive linear associations between higher levels of shared
decision-making practice and younger age, separated marital status, active employment, increased
trust in oncologists, short duration since diagnosis, and lower health literacy. The thematic analysis
depicted socio-demographic, psychological, communication and institutional factors affecting
practice of shared decision making in clinical care of women with cervical cancer.
Conclusions: The study emphasizes the complex interplay of socio-demographic, psychological,
communication, and institutional factors affecting practice of shared decision-making in the
clinical care of women with cervical cancer. Thus, understanding these dynamics may help to
enhance the practice of shared decision-making in the clinical care of women with cervical cancer.
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Keywords
Shared Decision Making, Cervical Cancer, Tikur Anbessa Specialized Hospital