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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2020

Open Access 01-12-2020 | NSCLC | Research

Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)

Authors: Cecilia Pompili, Patricia Holch, Zoe Rogers, Kate Absolom, Beverly Clayton, Kevin Franks, Hilary Bekker, Galina Velikova

Published in: Health and Quality of Life Outcomes | Issue 1/2020

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Abstract

Background

In early-stage Non-Small Cell Lung Cancer (NSCLC) patients, little is known about how to measure patient participation in Shared-Decision Making (SDM). We examined the psychometric properties and clinical acceptability of the Decision Self-Efficacy scale (DSE) in a cohort of patients undergoing to Stereotactic Ablative Radiotherapy (SABR) or Video-assisted Thoracoscopic Surgery (VATS) to capture patient involvement in treatment decisions.

Methods

In the context of a prospective longitudinal study (Life after Lung Cancer-LiLAC) involving 244 patients with early-stage NSCLC, 158 (64.7%) patients completed the DSE either on paper or electronically online prior to treatment with SABR or VATS pulmonary resection. DSE psychometric properties were examined using: principal components analysis of item properties and internal structure, and internal construct validity; we also performed a sensitivity analysis according to Eastern Cooperative Oncology Group Performance Status (ECOG PS), gender, age and treatment received (VATS or SABR) difference.

Results

Exploratory factor analysis using polychoric correlations substantiated that the 11 item DSE is one scale accounting for 81% of the variance. We calculated a value of 0.96 for Cronbach’s alpha for the total DSE score.
DSE scores did not differ by gender (p = 0.37), between the two treatment groups (p = 0.09) and between younger and older patients (p = 0.4). However, patients with an ECOG PS > 1 have a DSE mean of 73.8 (SD 26) compared to patients with a PS 0–1 who have a DSE mean of 85.8 (SD 20.3 p = 0.002).

Conclusion

Findings provide preliminary evidence for the reliability and validity of the DSE questionnaire in this population. However, future studies are warranted to identify the most appropriate SDM tool for clinical practice in the lung cancer treatment field.
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Literature
1.
Scott WJ, Howington J, Feigenberg S, Movsas B, Pisters K. Treatment of non-small cell lung cancer stage I and stage II: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):234s–42s.PubMedCrossRef
2.
Lim E, Baldwin D, Beckles M, Duffy J, Entwisle J, Faivre-Finn C, et al. Guidelines on the radical management of patients with lung cancer. Thorax. 2010;65(Suppl 3):iii1–27.PubMedCrossRef
3.
Louie AV, van Werkhoven E, Chen H, Smit EF, Paul MA, Widder J, et al. Patient reported outcomes following stereotactic ablative radiotherapy or surgery for stage IA non-small-cell lung cancer: results from the ROSEL multicenter randomized trial. Radiother Oncol. 2015;117(1):44–8.PubMedCrossRef
4.
Pompili C, Franks KN, Brunelli A, Hussain YS, Holch P, Callister ME, et al. Patient reported outcomes following video assisted thoracoscopic (VATS) resection or stereotactic ablative body radiotherapy (SABR) for treatment of non-small cell lung cancer: protocol for an observational pilot study (LiLAC). J Thorac Dis. 2017;9(8):2703–13.PubMedPubMedCentralCrossRef
5.
6.
Islam KM, Jiang X, Anggondowati T, Lin G, Ganti AK. Comorbidity and survival in lung Cancer patients. Cancer Epidemiol Biomarkers Prev. 2015;24(7):1079–85.PubMedCrossRef
7.
Tammemagi MC, Berg CD, Riley TL, Cunningham CR, Taylor KL. Impact of lung cancer screening results on smoking cessation. J Natl Cancer Inst. 2014;106(6):dju084.PubMedPubMedCentralCrossRef
8.
Franks K, Snee M, Naidu B, Sebag-Monterfiore D, Callister M, Ferguson J, Booton R, Kennedy M et al. SABRTOOTH: A Fasibility Study of SABR Versus Surgery in Patients with Peripheral Stage I NSCLC Considered to be at Higher Risk for Surgery. J Thorac Oncol. 2018;12(1):S631–32.
9.
Ackerson BG, Tong BC, Hong JC, Gu L, Chino J, Trotter JW, et al. Stereotactic body radiation therapy versus sublobar resection for stage I NSCLC. Lung Cancer. 2018;125:185–91.PubMedCrossRef
10.
Powell HA, Jones LL, Baldwin DR, Duffy JP, Hubbard RB, Tod AM, et al. Patients' attitudes to risk in lung cancer surgery: a qualitative study. Lung Cancer. 2015;90(2):358–63.PubMedCrossRef
11.
Mokhles S, Maat A, Aerts J, Nuyttens J, Bogers A, Takkenberg JJM. Opinions of lung cancer clinicians on shared decision making in early-stage non-small-cell lung cancer. Interact Cardiovasc Thorac Surg. 2017;25(2):278–84.PubMedCrossRef
12.
Hopmans W, Damman OC, Senan S, Hartemink KJ, Smit EF, Timmermans DRM. A patient perspective on shared decision making in stage I non-small cell lung cancer: a mixed methods study. BMC Cancer. 2015;15(1):959.PubMedPubMedCentralCrossRef
13.
Sullivan DR, Eden KB, Dieckmann NF, Golden SE, Vranas KC, Nugent SM, et al. Understanding patients' values and preferences regarding early stage lung cancer treatment decision making. Lung Cancer. 2019;131:47–57.PubMedPubMedCentralCrossRef
14.
Gartner FR, Bomhof-Roordink H, Smith IP, Scholl I, Stiggelbout AM, Pieterse AH. The quality of instruments to assess the process of shared decision making: a systematic review. PLoS One. 2018;13(2):e0191747.PubMedPubMedCentralCrossRef
15.
Chen HL, Liu K, You QS. Self-efficacy, cancer-related fatigue, and quality of life in patients with resected lung cancer. Eur J Cancer Care. 2018;27(6):e12934.CrossRef
16.
AM OC. User manual – decision self-efficacy scale. Ottawa: Ottawa Hospital Research Institute; 1995.
17.
18.
Sloan JA, Dueck AC, Erickson PA, Guess H, Revicki DA, Santanello NC. Analysis and interpretation of results based on patient-reported outcomes. Value Health. 2007;10(Suppl 2):S106–15.PubMedCrossRef
19.
Fayers PMAN, Bjordal K, Groenvold M, Curran D, Bottomley A, on behalf of the EORTC Quality of Life Group. The EORTC QLQ-C30 Scoring Manual. 3rd ed; 2001.
20.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol. 1982;5(6):649–55.PubMedCrossRef
21.
Karnofsky D, Burchenal J. The clinical evaluation of chemotherapeutic agents in Cancer; 1949.
22.
Taylor AE, Olver IN, Sivanthan T, Chi M, Purnell C. Observer error in grading performance status in cancer patients. Support Care Cancer. 1999;7(5):332–5.PubMedCrossRef
23.
Ma C, Bandukwala S, Burman D, Bryson J, Seccareccia D, Banerjee S, et al. Interconversion of three measures of performance status: an empirical analysis. Eur J Cancer. 2010;46(18):3175–83.PubMedCrossRef
24.
MacCallum RC, Widaman KF, Zhang S, Hong S. Sample size in factor analysis. Psychol Methods. 1999;4(1):84–99.CrossRef
25.
Bunn H, O'Connor A. Validation of client decision-making instruments in the context of psychiatry. Can J Nurs Res. 1996;28(3):13–27.PubMed
26.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.PubMedCrossRef
27.
Nunnally JC. Psychometric theory 3E: Tata McGraw-hill education; 1994.
28.
29.
Thorndike RM. Book review : psychometric theory (3rd ed.) by Jum Nunnally and Ira Bernstein New York: McGraw-hill, 1994, xxiv + 752 pp. Appl Psychol Meas. 1995;19(3):303–5.CrossRef
30.
Muthen B, Kaplan D. A comparison of some methodologies for the factor analysis of non-normal Likert variables: A note on the size of the model. Brit J Math Stat Psy. 1992;45(1):19–30.
31.
Buja A, Eyuboglu N. Remarks on parallel analysis. Multivar Behav Res. 1992;27(4):509–40.CrossRef
32.
33.
Firat S, Byhardt RW, Gore E. Comorbidity and Karnofksy performance score are independent prognostic factors in stage III non-small-cell lung cancer: an institutional analysis of patients treated on four RTOG studies. Int J Radiat Oncol Biol Phys. 2002;54(2):357–64.PubMedCrossRef
34.
Cerny T, Anderson H, Bramwell V, Thatcher N, Blair V. Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients. Int J Cancer. 1987;39(2):146–9.
35.
Hopmans W, Zwaan L, Senan S, van der Wulp I, Damman OC, Hartemink KJ, et al. Differences between pulmonologists, thoracic surgeons and radiation oncologists in deciding on the treatment of stage I non-small cell lung cancer: a binary choice experiment. Radiother Oncol. 2015;115(3):361–6.PubMedCrossRef
36.
Ghadiri R, Alimohammadi M, Majdabadi HA. Determination of the psychometric properties of the Patients' self-efficacy scale in blood pressure patients. Interv Med Appl Sci. 2018;10(2):87–94.PubMedPubMedCentral
37.
Degner LF, Sloan JA. Decision making during serious illness: what role do patients really want to play? J Clin Epidemiol. 1992;45(9):941–50.PubMedCrossRef
38.
Siminoff LA, Fetting JH. Factors affecting treatment decisions for a life-threatening illness: the case of medical treatment of breast cancer. Soc Sci Med (1982). 1991;32(7):813–8.CrossRef
39.
Snee MP, McParland L, Collinson F, Lowe CM, Striha A, Baldwin DR, et al. The SABRTooth feasibility trial protocol: a study to determine the feasibility and acceptability of conducting a phase III randomised controlled trial comparing stereotactic ablative radiotherapy (SABR) with surgery in patients with peripheral stage I non-small cell lung cancer (NSCLC) considered to be at higher risk of complications from surgical resection. Pilot Feasibility Stud. 2016;2:5.PubMedPubMedCentralCrossRef
40.
Durand MA, Bekker HL, Casula A, Elias R, Ferraro A, Lloyd A, et al. Can we routinely measure patient involvement in treatment decision-making in chronic kidney care? A service evaluation in 27 renal units in the UK. Clin Kidney J. 2016;9(2):252–9.PubMedPubMedCentralCrossRef
41.
Ferron Parayre A, Labrecque M, Rousseau M, Turcotte S, Legare F. Validation of SURE, a four-item clinical checklist for detecting decisional conflict in patients. Med Decis Making. 2014;34(1):54–62.PubMedCrossRef
42.
O'Connor AM, Drake ER, Wells GA, Tugwell P, Laupacis A, Elmslie T. A survey of the decision-making needs of Canadians faced with complex health decisions. Health Expect. 2003;6(2):97–109.PubMedPubMedCentralCrossRef
43.
Legare F, Kearing S, Clay K, Gagnon S, D'Amours D, Rousseau M, et al. Are you SURE?: assessing patient decisional conflict with a 4-item screening test. Can Fam Physician. 2010;56(8):e308–14.PubMedPubMedCentral
Metadata
Title
Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)
Authors
Cecilia Pompili
Patricia Holch
Zoe Rogers
Kate Absolom
Beverly Clayton
Kevin Franks
Hilary Bekker
Galina Velikova
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-020-01496-9

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