TY - JOUR
T1 - Difficult choices for young patients with cancer
T2 - the supportive role of decisional counseling
AU - Chiavari, Leonora
AU - Gandini, Sara
AU - Feroce, Irene
AU - Guerrieri-Gonzaga, Aliana
AU - Russell-Edu, William
AU - Bonanni, Bernardo
AU - Peccatori, Fedro Alessandro
PY - 2015/4/11
Y1 - 2015/4/11
N2 - Purpose: The aim of patient decisional support interventions is to promote shared decision making. Many of these interventions are comprehensive of information and guidance. In this pilot study, we evaluate the effects of a decision-making support (decision counseling (DeCo)) on decision making, decisional conflict, and anxiety in cancer patients facing with values-based decisions on fertility and procreation or genetic testing and risk reduction options in oncology. Methods: DeCo was proposed during the medical consultation. The following questionnaires were administered to 54 patients before the DeCo session and 1 week after it: stage of decision making (SDM), decisional conflict scale (DCS) and subscales (“uncertainty,” “informed,” ”clarity,” “support,” and “effective decision”), state-trait anxiety inventory. Decision Support Questionnaire and Usefulness of Decision Counseling were created ad hoc for this study. Multivariate logistic models and ANCOVA models were used to investigate the changes of SDM and DCS in association with DeCo. Results: We found a significant improving in SDM with DeCo (P = 0.01) and a significant reduction in DCS with DeCo (P = 0.007) measured with the Decision Support Questionnaire. In particular, the DCS informed subscale showed a significant decrease in time (P = 0.002). Conclusion: DeCo is useful to facilitate decision making and reduce decisional conflict. It plays a role in the perception of being informed while not directly providing clinical information. This model of decisional support intervention, in which information is provided only by the clinician and decisional support is focused on personal aspects that influence the decision, could improve shared decision making between patient and clinicians.
AB - Purpose: The aim of patient decisional support interventions is to promote shared decision making. Many of these interventions are comprehensive of information and guidance. In this pilot study, we evaluate the effects of a decision-making support (decision counseling (DeCo)) on decision making, decisional conflict, and anxiety in cancer patients facing with values-based decisions on fertility and procreation or genetic testing and risk reduction options in oncology. Methods: DeCo was proposed during the medical consultation. The following questionnaires were administered to 54 patients before the DeCo session and 1 week after it: stage of decision making (SDM), decisional conflict scale (DCS) and subscales (“uncertainty,” “informed,” ”clarity,” “support,” and “effective decision”), state-trait anxiety inventory. Decision Support Questionnaire and Usefulness of Decision Counseling were created ad hoc for this study. Multivariate logistic models and ANCOVA models were used to investigate the changes of SDM and DCS in association with DeCo. Results: We found a significant improving in SDM with DeCo (P = 0.01) and a significant reduction in DCS with DeCo (P = 0.007) measured with the Decision Support Questionnaire. In particular, the DCS informed subscale showed a significant decrease in time (P = 0.002). Conclusion: DeCo is useful to facilitate decision making and reduce decisional conflict. It plays a role in the perception of being informed while not directly providing clinical information. This model of decisional support intervention, in which information is provided only by the clinician and decisional support is focused on personal aspects that influence the decision, could improve shared decision making between patient and clinicians.
KW - Decision counseling
KW - Decision support
KW - Patient decision aids
KW - Shared decision making
KW - Values-based decisions
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U2 - 10.1007/s00520-015-2726-5
DO - 10.1007/s00520-015-2726-5
M3 - Article
C2 - 25862346
AN - SCOPUS:84945452465
VL - 23
SP - 3555
EP - 3562
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
IS - 12
ER -