Top

Supportive Care in Cancer

Published in:

01-11-2013 | Original Article

Predictors of satisfaction with treatment decision, decision-making preferences, and main treatment goals in patients with advanced cancer

Authors: Felicitas Hitz, Karin Ribi, Qiyu Li, Dirk Klingbiel, Thomas Cerny, Dieter Koeberle

Published in: Supportive Care in Cancer | Issue 11/2013

Abstract

Purpose

This study investigated satisfaction with treatment decision (SWTD), decision-making preferences (DMP), and main treatment goals, as well as evaluated factors that predict SWTD, in patients receiving palliative cancer treatment at a Swiss oncology network.

Patients and methods

Patients receiving a new line of palliative treatment completed a questionnaire 4–6 weeks after the treatment decision. Patient questionnaires were used to collect data on sociodemographics, SWTD (primary outcome measure), main treatment goal, DMP, health locus of control (HLoC), and several quality of life (QoL) domains. Predictors of SWTD (6 = worst; 30 = best) were evaluated by uni- and multivariate regression models.

Results

Of 480 participating patients in eight hospitals and two private practices, 445 completed all questions regarding the primary outcome measure. Forty-five percent of patients preferred shared, while 44 % preferred doctor-directed, decision-making. Median duration of consultation was 30 (range: 10–200) minutes. Overall, 73 % of patients reported high SWTD (≥24 points). In the univariate analyses, global and physical QoL, performance status, treatment goal, HLoC, prognosis, and duration of consultation were significant predictors of SWTD. In the multivariate analysis, the only significant predictor of SWTD was duration of consultation (p = 0.01). Most patients indicated hope for improvement (46 %), followed by hope for longer life (26 %) and better quality of life (23 %), as their main treatment goal.

Conclusion

Our results indicate that high SWTD can be achieved in most patients with a 30-min consultation. Determining the patient’s main treatment goal and DMP adds important information that should be considered before discussing a new line of palliative treatment.

Available only for authorised users

Korsch BM, Gozzi EK, Francis V (1968) Gaps in doctor–patient communication. 1. Doctor–patient interaction and patient satisfaction. Pediatrics 42:855–871PubMed

Zachariae R, Pedersen CG, Jensen AB et al (2003) Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. Br J Cancer 88:658–665PubMedCrossRef

Hall JA, Roter DL, Katz NR (1988) Meta-analysis of correlates of provider behavior in medical encounters. Med Care 26:657–675PubMedCrossRef

Epstein RM, Street R Jr (2007) Patient-centered communication in cancer care: promoting healing and reducing suffering. National Cancer Institute, Bethesda

Leighl NB, Shepherd HL, Butow PN et al (2011) Supporting treatment decision making in advanced cancer: a randomized trial of a decision aid for patients with advanced colorectal cancer considering chemotherapy. J Clin Oncol 29:2077–2084PubMedCrossRef

Degner LF, Kristjanson LJ, Bowman D et al (1997) Information needs and decisional preferences in women with breast cancer. JAMA 277:1485–1492PubMedCrossRef

Weeks JC, Catalano PJ, Cronin A, Finkelman MD, Mack JW, Keating NL, Schrag D (2012) Patients’ expectations about effect of chemotherapy for advanced cancer. NEJM 367:1616–1625PubMedCrossRef

Leighl NB, Butow PN, Tattersall MHN (2004) Treatment decision aids in advanced cancer: when the goal is not cure and the answer is not clear. J Clin Oncol 22:1759–1762PubMedCrossRef

O’Connor AM, Rostom A, Fiset V, Tetroe J, Entwistle V, Llewellyn-Thomas H, Holmes-Rovner M, Barry M, Jones J (1999) Decision aids for patients facing health treatment or screening decisions: systemic review. BMJ 319:731–734PubMedCrossRef

10.

Molenaar S, Sprangers MA, Postma- Schmit FC et al (2000) Feasibility and effects of decision aids. Med Decis Making 20:112–127PubMedCrossRef

11.

Committee on Quality of Health Care in America IoM (2001) Crossing the quality chasm: a new health system for the 21st century. National Academies Press, Washington, DC

12.

Kuehn BM (2012) Patient-centered care model demands better physician–patient communication. JAMA 307:441–442PubMedCrossRef

13.

Kissane DW, Bylund CL, Banerjee SC, Bialer PA, Levin TT, Maloney EK, D’Agostino TA (2012) Communication skills training for oncology professionals. J Clin Oncol 30:1242–1247PubMedCrossRef

14.

Haidet P, Fecile ML, West HF et al (2009) Reconsidering the team concept: educational implications for patient-centered cancer care. Patient Educ Couns 77:450–455PubMedCrossRef

15.

Politi MC, Studts JL, Hayslip JW (2012) Shared decision making in oncology practice: what do oncologists need to know? Oncologist 17:91–100PubMedCrossRef

16.

Daneault S, Dion D, Sicotte C, Yelle L, Mongeau S, Lussier V, Coulombe M, Paillé P (2010) Hope and noncurative chemotherapies: which affects the other? J Clin Oncol 28:2310–2313PubMedCrossRef

17.

Ware JE Jr, Snyder MK, Wright WR et al (1983) Defining and measuring patient satisfaction with medical care. Eval Program Plann 6:247–263PubMedCrossRef

18.

Holmes-Rovner M, Kroll J, Schmitt N et al (1996) Patient satisfaction with health care decisions: the satisfaction with decision scale. Med Decis Making 16:58–64PubMedCrossRef

19.

Degner LF, Sloan JA, Venkatesh P (1997) The Control Preferences scale. Can J Nurs Res 29:21–43PubMed

20.

Lohaus A, Schmitt GM (1989) Control beliefs concerning illness and health: report on the development of a testing procedure. Diagnostica 35:59–72

21.

Wallston KA, Wallston BS, DeVellis R (1978) Development of the Multidimensional Health Locus of Control (MHLC) scales. Health Educ Monogr 6:160–170PubMedCrossRef

22.

Butow P, Coates A, Dunn S, Bernhard J, Hurny C (1991) On the receiving end. IV: validation of quality of life indicators. Ann Oncol 2:597–603PubMed

23.

Bernhard J, Maibach R, Thurlimann B et al (2002) Patients’ estimation of overall treatment burden: why not ask the obvious? J Clin Oncol 20:65–72PubMedCrossRef

24.

Hürny C, Wegberg B, Bacchi M, Bernhard J, Thürlimann B, Real O, Perey L, Bonnefoi H, Coates A (1998) Subjective health estimations (SHE) in patients with advanced breast cancer: an adapted utility concept for clinical trials. Br J Cancer 77:985–991PubMedCrossRef

25.

Bernhard J, Dietrich D, Scheithauer W et al (2008) Clinical benefit and quality of life in patients with advanced pancreatic cancer receiving gemcitabine plus capecitabine versus gemcitabine alone: a randomized multicenter phase III clinical trial—SAKK 44/00-CECOG/PAN.1.3.001. J Clin Oncol 26:3695–3701PubMedCrossRef

26.

Kollbrunner J, Zbaren P, Quack K (2001) Quality of life stress in patients with large tumors of the mouth. 2: Dealing with the illness: coping, anxiety and depressive symptoms. HNO 49:998–1007PubMedCrossRef

27.

Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Taylor & Francis, New York

28.

Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–334CrossRef

29.

Van Buuren S, Groothuis-Oudshoorn K (2011) Multivariate imputation by chained equations in R. J Stat Softw 45:1–67

30.

Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20:37–46CrossRef

31.

Deveugele M, Derese A, van den Brink-Muinen A et al (2002) Consultation length in general practice: cross sectional study in six European countries. BMJ 325:472PubMedCrossRef

32.

Hamidou Z, Dabakuyo TS, Bonnetain F (2011) Impact of response shift on longitudinal quality-of-life assessment in cancer clinical trials. Expert Rev Pharmacoecon Outcomes Res 11:549–559PubMedCrossRef

33.

Stewart M, Brown JB, Donner A (2000) The impact of patient-centered care on outcomes. J Fam Pract 49:796–804PubMed

34.

Makoul G, Arntson P, Schofield T (1995) Health promotion in primary care: physician–patient communication and decision making about prescription medications. Soc Sci Med 41:1241–1254PubMedCrossRef

35.

Barry MJ, Edgman-Levitan S (2012) Shared decision making—pinnacle of patient-centered care. N Engl J Med 366:780–781PubMedCrossRef

36.

Bruera E, Sweeney C, Calder K, Palmer L, Benisch-Tolley S (2001) Patient preferences versus physician perceptions of treatment decisions in cancer care. J Clin Oncol 19:2883–2885PubMed

37.

Elkin EB, Kim SH, Casper ES, Kissane DW, Schrag D (2007) Desire for information and involvement in treatment decisions: elderly cancer patients’ preferences and their physicians’ perceptions. J Clin Oncol 25:5275–5280PubMedCrossRef

38.

Bruera E, Willey JS, Palmer JL, Rosales M (2002) Treatment decisions for breast carcinoma: patient preferences and physician perceptions. Cancer 94:2076–2080PubMedCrossRef

39.

Mandelblatt J, Kreling B, Figeuriedo M, Feng S (2006) What is the impact of shared decision making on treatment and outcomes for older women with breast cancer? J Clin Oncol 24:4908–4913PubMedCrossRef

40.

Janz NK, Wren PA, Copeland LA, Lowery JC, Goldfarb SL, Wilkins EG (2004) Patient–physician concordance: preferences, perceptions, and factors influencing the breast cancer surgical decision. J Clin Oncol 22:3091–3098PubMedCrossRef

41.

Gattellari M, Butow PN, Tattersall MH (2001) Sharing decisions in cancer care. Soc Sci Med 52:1865–1878PubMedCrossRef

42.

Noble LM, Kubacki A, Martin J, Lloyd M (2007) The effect of professional skills training on patient-centredness and confidence in communicating with patients. Med Educ 41:432–440PubMedCrossRef

43.

Voogt E, van der Heide A, Rietjens JA et al (2005) Attitudes of patients with incurable cancer toward medical treatment in the last phase of life. J Clin Oncol 23:2012–2019PubMedCrossRef

44.

Stiggelbout AM, de Haes JC, Kiebert GM et al (1996) Tradeoffs between quality and quantity of life: development of the QQ Questionnaire for Cancer Patient Attitudes. Med Decis Making 16:184–192PubMedCrossRef

45.

Renz M, Koeberle D, Cerny T, Strasser F (2008) Between utter despair and essential hope. J Clin Oncol 27:146–149PubMedCrossRef

Title: Predictors of satisfaction with treatment decision, decision-making preferences, and main treatment goals in patients with advanced cancer
Authors: Felicitas Hitz
Karin Ribi
Qiyu Li
Dirk Klingbiel
Thomas Cerny
Dieter Koeberle
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 11/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-013-1886-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2013

Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes

Usefulness of the PERFORM questionnaire to measure fatigue in cancer patients with anemia: a prospective, observational study

Optimal control of nausea and vomiting with a three-drug antiemetic regimen with aprepitant in metastatic pancreatic cancer patients treated with first-line modified FOLFIRINOX

Palliative and oncologic co-management: symptom management for outpatients with cancer

Comparison of modified Borg scale and visual analog scale dyspnea scores in predicting re-intervention after drainage of malignant pleural effusion

Dr. Yojiro Ota

Keynote webinar | Spotlight on antibody–drug conjugates in cancer