Conclusion
ADVANCED CANCER
The current study shows a relationship between SDM and adverse outcomes in patients with advanced cancer; specifically, an increase in tension and uncertainty was observed to coincide with more SDM. It is important for oncologists to realize that short-term negative emotions might occur for patients when engaging in SDM, for which oncologists could be equipped through future SDM training programs addressing this issue. The current oncologist SDM training did not affect adverse outcomes. Although our results do not show what the exact cause of adverse outcomes might be, they do show that the element of informing patients might specifically be associated with short-term adverse outcomes (i.e., patients might temporarily feel more tense and more helpless or hopeless when adequate information is given in order to decide on treatment). However, further research is needed to untangle exactly which, when, and how adverse outcomes of SDM might occur, how patients experience these, and how burden might be minimized.