Decisional Conflict after Deciding on Potential Participation in Early Phase Clinical Cancer Trials: Dependent on Global Health Status, Satisfaction with Communication, and Timing

Liza G.G. van Lent*, Maja J.A. de Jonge, Mirte van der Ham, Marjolein van Mil, Eelke H. Gort, Jeroen Hasselaar, Esther Oomen De Hoop, Carin C.D. van der Rijt, Julia C.M. van Weert, Martijn P. Lolkema

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

When standard treatment options are not available anymore, patients with advanced cancer may participate in early phase clinical trials. Improving this complex decision-making process may improve their quality of life. Therefore, this prospective multicenter study with questionnaires untangles several contributing factors to decisional conflict (which reflects the quality of decisionmaking) in patients with advanced cancer who recently decided upon early phase clinical trial participation (phase I or I/II). We hypothesized that health-related quality of life, health literacy, sense of hope, satisfaction with the consultation, timing of the decision, and the decision explain decisional conflict. Mean decisional conflict in 116 patients was 30.0 (SD = 16.9). Multivariate regression analysis showed that less decisional conflict was reported by patients with better global health status (β = −0.185, p = 0.018), higher satisfaction (β = −0.246, p = 0.002), and who made the decision before (β = −0.543, p < 0.001) or within a week after the consultation (β = −0.427, p < 0.001). These variables explained 37% of the variance in decisional conflict. Healthcare professionals should realize that patients with lower global health status and who need more time to decide may require additional support. Although altering such patient intrinsic characteristics is difficult, oncologists can impact the satisfaction with the consultation. Future research should verify whether effective patient-centered communication could prevent decisional conflict.

Original languageEnglish
Article number1500
JournalCancers
Volume14
Issue number6
DOIs
Publication statusPublished - 15 Mar 2022

Bibliographical note

Funding Information: Funding: This research was funded by the Dutch Cancer Society, grant number KWF 11086.

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

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