Published in PLOS One on 2026-04-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Sosina Workineh Tilahun, Adiam Nega, Lealem Wagaw, Adamu Addissie
Source: PLOS One • DOI 10.1371/journal.pone.0348172
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Shared decision-making is crucial for alignment of treatment options with patient values and preferences. However, currently in Ethiopia, shared decision-making in clinical care of cancer, in which cervical cancer is not exceptional, is not well understood.
This study aimed to assess the perceived level of shared decision-making and its predictors in cervical cancer care at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia.
We employed a convergent parallel mixed-methods study design from February 18 to May 23, 2025, at Tikur Anbessa Specialized Hospital. The study used interviewer-administered questionnaires for 203 cervical cancer patients and in-depth interviews for 15 cervical cancer patients and 10 clinical oncologists. Using SPSS v26, multiple linear regression analysis was used to determine significant predictors of the perceived level of shared decision-making, with statistical significance set at P < 0.05. Thematic analysis was conducted for the qualitative data.
The overall mean score for the perceived level of shared decision-making was 24.94 (± 9.12), with a range of 7–44, and the standardized mean score was 2.77 (± 1.01). The perceived level of shared decision-making had positive linear associations with increased trust in oncologists (0.32, 95% CI (0.21, 0.44); p < 0.001). Conversely, it had negative linear associations with rural residential area (−2.94, 95% CI (−5.34, −0.54); p = 0.02), unemployment status (−4.36, 95% CI (−6.96, −1.76); p = 0.001), and higher health literacy score (−6.89, 95% CI (−9.92–-3.86); p < 0.001). Thematic analysis revealed contextual, cultural, relational, institutional, and communicational factors influencing shared decision-making practice in cervical cancer care.
The study emphasized the complex interplay of factors influencing the practice of shared decision-making in clinical care of cervical cancer. Therefore, understanding these dynamics may help to enhance the practice of shared decision-making in clinical cervical cancer care.
Background
For decades, physicians were solely responsible for determining patients’ treatment plans, with little to no input from the patients [1,2]. However, contemporary medicine emphasizes that medical professionals are supposed to recommend clinical care interventions based on their expertise, which patients can accept or reject. This shift reflects a transformation in modern medicine and highlights the importance of involving patients in their clinical care, giving rise to the practice of shared decision-making (SDM) [2].
SDM suggests treatment decisions are made only after the patient fully understands the entire treatment plan, including its potential risks and benefits [3,4]. It empowers patients to make decisions based on their values, preferences, and experiences, solidifying its role as a fundamental aspect of patient-centered care [5–8]. Beyond its ethical and relational importance, implementing SDM in clinical practice has been associated with positive affective and cognitive outcomes [9]. Research from developed countries highlights its practical advantages, such as increased patient satisfaction, better cost-effectiveness, and a reduction in malpractice lawsuits [10,11]. Shared decision-making is not only a legal and ethical requirement strongly endorsed by medical associations but also a collaborative form of work that demands effort, negotiation, and institutional support to overcome power asymmetries and achieve true patient-centered care [12]. Conversely, inadequate application of SDM is associated with poorer health outcomes, lower quality of care, and increased healthcare utilization, which can be described as more hospital visits and resource use [13].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Sosina Workineh Tilahun, Adiam Nega, Lealem Wagaw, Adamu Addissie. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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