We sought to construct and validate a model of cancer surgeon approaches to patient-centered decision-making (PCDM) and compare applications of that model relative to surgical specialties. Ten PCDM strategies were assessed using a cross-sectional survey administered online to 295 board-certified cancer surgeons. Structural equation modeling was used to empirically validate and compare approaches to PCDM. Within the full sample, 7 strategies comprised a latent construct labeled, “physical & emotional accessibility,” associated with surgeon approaches to PCDM (β = 0.37, p < .05). Three individual strategies were included: “expectations (Q4)” (β = 0.52, p < .05), “decision preferences (Q5) (β = 0.47, p < .05), and “access medical information (Q3)” (β = 0.75). Surgical specialties for subgroup analysis were classified as general/other (67.6%) or hepato-pancreato-biliary and upper gastrointestinal (HPB/UGI) (34.2%). For general/other surgeons, 7 individual strategies composed the model of surgeon approaches to PCDM, with “time (Q6) (β = 0.70, p < .001) and “therapeutic relationship building (Q9)” (β = 0.69, p < .001) being the strongest predictors. The HPB/UGI model included 2 latent constructs labeled “physical accessibility” (β = 0.72, p < .05) and “creating a decision-making dialogue” (β = 0.62) as well as the individual strategy, “effective communication (Q8)” (β = 0.51, p < .05). Although models of surgeon PCDM varied, there were 4 overlapping strategies, including effective communication. Tailoring models of PCDM may improve surgeon uptake and thus, overall patient satisfaction with their cancer care.

我们试图构建和验证癌症外科医生以患者为中心的决策 (PCDM) 方法模型，并比较该模型相对于外科专业的应用。通过在线对 295 名获得委员会认证的癌症外科医生进行的横断面调查，评估了 10 种 PCDM 策略。结构方程模型被用来根据经验验证和比较 PCDM 的方法。在完整样本中，7 种策略包含一个标记为“身体和情感可及性”的潜在结构，与外科医生对 PCDM 的处理方法相关 ( β  = 0.37，p  < .05)。包括三个单独的策略：“期望（Q4）”（β  = 0.52，p  <.05），“决策偏好（Q5）（β  = 0.47， p <.05）p  < .05) 和“访问医疗信息 (Q3)” ( β  = 0.75)。用于亚组分析的外科专业被分类为普通/其他 (67.6%) 或肝胰胆和上消化道 (HPB/UGI) (34.2%)。对于普通/其他外科医生，7 个单独的策略构成了外科医生对 PCDM 方法的模型，其中“时间 (Q6) ( β  = 0.70, p  < .001) 和“治疗关系建立 (Q9)” ( β  = 0.69, p  < .001) 是最强的预测因子。HPB/UGI 模型包括 2 个标记为“物理可访问性”（β  = 0.72，p  <.05）和“创建决策对话”（β = 0.62) 以及个人策略，“有效沟通 (Q8)”（β  = 0.51，p  < .05）。尽管外科医生 PCDM 的模型各不相同，但有 4 种重叠策略，包括有效沟通。定制 PCDM 模型可以提高外科医生的接受度，从而提高患者对其癌症护理的整体满意度。