Decision-Making Preferences among Advanced Cancer Patients in a Palliative Setting in Jordan

Omar Shamieh*, Ghadeer Alarjeh, Mohammad Al Qadire, Waleed Alrjoub, Mahmoud Abu-Nasser, Fadi Abu Farsakh, Abdelrahman AlHawamdeh, Mohammad Al-Omari, Zaid Amin, Omar Ayaad, Amal Al-Tabba, David Hui, Eduardo Bruera, Sriram Yennurajalingam

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Understanding patients’ decision-making preferences is crucial for enhancing patients’ outcomes. The current study aims to identify Jordanian advanced cancer patients’ preferred decision-making and to explore the associated variables of the passive decision-making preference. We used a cross-sectional survey design. Patients with advanced cancer referred to the palliative care clinic at a tertiary cancer center were recruited. We measured patients’ decision-making preferences using the Control Preference Scale. Patients’ satisfaction with decision-making was assessed with the Satisfaction with Decision Scale. Cohen’s kappa statistic was used to assess the agreement between decision-control preferences and actual decision-making, and the bivariate analysis with 95% CI and the univariate and multivariate logistic regression were used to examine the association and predictors of the demographical and clinical characteristics of the participants and the participants’ decision-control preferences, respectively. A total of 200 patients completed the survey. The patients’ median age was 49.8 years, and 115 (57.5%) were female. Of them, 81 (40.5%) preferred passive decision control, and 70 (35%) and 49 (24.5%) preferred shared and active decision control, respectively. Less educated participants, females, and Muslim patients were found to have a statistically significant association with passive decision-control preferences. Univariate logistic regression analysis showed that, being a male (p = 0.003), highly educated (p = 0.018), and a Christian (p = 0.006) were statistically significant correlates of active decision-control preferences. Meanwhile, the multivariate logistic regression analysis showed that being a male or a Christian were the only statistically significant predictors of active participants’ decision-control preferences. Around 168 (84%) of participants were satisfied with the way decisions were made, 164 (82%) of patients were satisfied with the actual decisions made, and 143 (71.5%) were satisfied with the shared information. The agreement level between decision-making preferences and actual decision practices was significant (ⱪ coefficient = 0.69; 95% CI = 0.59 to 0.79). The study’s results demonstrate that a passive decision-control preference was prominent among patients with advanced cancer in Jordan. Further studies are needed to evaluate decision-control preference for additional variables, such as patients’ psychosocial and spiritual factors, communication, and information sharing preferences, throughout the cancer trajectory so as to inform policies and improve practice.

Original languageEnglish
Article number5550
JournalInternational Journal of Environmental Research and Public Health
Issue number8
Publication statusPublished - Apr 2023


  • Jordan
  • cancer
  • communication
  • decision control
  • palliative care
  • patient satisfaction

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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