Mariken Stegmann

participate in SDM. 15  Self‐efcacy is increasingly viewed as being central to the way  patients with cancer cope with their disease, its treatment, and the decisions they  make. 16,17 The OPTion study  Rationale  Oncologists often lack prior knowledge of the patient and have only limited time to discuss  treatment options, making SDM difcult to implement. The GP, by contrast, is better  placed to talk about treatment with patients because they share a longer relationship, with  a greater understanding of both the patient and his or her context. We therefore reasoned  that the SDM process would benet from GPs helping to prepare patients for conversations  with their oncologist. In palliative settings, we think this might increase patient self‐efcacy  and facilitate personalised treatment decisions when used in collaboration with routine  oncology consultations. Therefore, we aim to develop a randomised controlled trial of the  effect on decision self‐efcacy of structured conversations between GPs and older patients  with cancer in palliative settings. We propose that these conversations will focus on generic  treatment goals just before a treatment decision needs to be made, and that they should  be performed using a standardised format. Figure 1. Graph showing the proposed measurements at the various time points.  20 Chapter 2