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The current study explored whether SDM, and an oncologist training in SDM, are associated with adverse outcomes (i.e., patient anxiety, tension, helplessness\/hopelessness, decisional uncertainty, and reduced fighting spirit).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A secondary analysis of a randomized clinical trial investigating the effects of SDM interventions in the context of advanced cancer. The relations between observed SDM (OPTION12), specific SDM elements (4SDM), oncologist SDM training, and adverse outcomes were analyzed. We modeled adverse outcomes as a multivariate phenomenon, followed by univariate regressions if significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 194 patients consulted by 31 oncologists were included. In a multivariate analysis, observed SDM and adverse outcomes were significantly related. More specifically, more observed SDM in the consultation was related to patients reporting more tension (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.002) and more decisional uncertainty (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.004) at 1 wk after the consultation. The SDM element \u201cinforming about the options\u201d was especially found to be related to adverse outcomes, specifically to more helplessness\/hopelessness (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.002) and more tension (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.016) at 1 wk after the consultation. Whether the patient consulted an oncologist who had received SDM training or not was not significantly related to adverse outcomes. No relations with long-term adverse outcomes were found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It is important for oncologists to realize that for some patients, SDM may temporarily be associated with negative emotions. Further research is needed to untangle which, when, and how adverse outcomes might occur and whether and how burden may be minimized for patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Observed shared decision making was related to more tension and uncertainty postconsultation in advanced cancer patients<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>However, training oncologists in SDM did not affect adverse outcomes.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Further research is needed to untangle which, when, and how adverse outcomes might occur and how burden may be minimized<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1177\/0272989x231208448","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T01:39:05Z","timestamp":1699839545000},"page":"89-101","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Potential Adverse Outcomes of Shared Decision Making about Palliative Cancer Treatment: A Secondary Analysis of a Randomized Trial"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-4405","authenticated-orcid":false,"given":"Lo\u00efs F.","family":"van de Water","sequence":"first","affiliation":[{"name":"Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2351-0068","authenticated-orcid":false,"given":"Danique W.","family":"Bos\u2013van den Hoek","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Kuijper","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke W. M.","family":"van Laarhoven","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert-Jan","family":"Creemers","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Catharina Ziekenhuis, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge E.","family":"Dohmen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, BovenIJ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle-Brit","family":"Fiebrich","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Isala Klinieken, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petronella B.","family":"Ottevanger","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirkje W.","family":"Sommeijer","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Flevoziekenhuis, Almere, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip Y. 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