Asian Oncol Nurs.  2017 Jun;17(2):69-78. 10.5388/aon.2017.17.2.69.

Factors Influencing Conflicts of Chemotherapy Decision Making among Pre-Operative Cancer Patients

• Koo NY
• Lee JH

• KMID: 2386658
• DOI: http://doi.org/10.5388/aon.2017.17.2.69

Abstract

PURPOSE
This study was attempted to grasp the factors affecting the decision-making conflicts of preoperative cancer patients.
METHODS
The subjects of this study were 110 cancer patients scheduled to undergo surgeries at K university hospital. Data were collected utilizing scales for decision-making conflicts and anxiety state, and measurement tools for attitude toward treatment and, shared decision-making.
RESULTS
The level of decision-making conflicts over cancer treatment of preoperative cancer patients turned out to be slightly lower than the median. There were significant correlations between shared decision-making between physicians and patients, and quality of life which was a subdomain of attitude toward treatment. In multiple regression analysis, the most powerful predictor was the shared decision-making of physicians and patients. Overall, the explanatory power of the measured variables for decisionmaking conflicts about cancer therapy was 20%.
CONCLUSION
The study highlights the importance of shared decision-making and quality of life which involves attitude toward treatment. Thereby, it is deemed to be necessary to develop intervention strategies regarding decision-making conflicts about cancer treatment in consideration of these variables.

Keyword

Neoplasms; Decision Making; Conflict; Attitude; Anxiety

MeSH Terms

Anxiety
Decision Making*
Drug Therapy*
Hand Strength
Humans
Quality of Life
Weights and Measures

Reference

1. 1. Korean Statistical Information Service(KR). Statistics of Surgical Op-erations& Covered by& NHI[Internet]. Available from. http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=TX_35004_A015&conn_path=13. [Accessed January_12,_2017].

2. Korean Oncology Nursing Society. Oncology nursing: treatment and care. 2nd ed.Seoul: Fornurse;2014.

3. So HS, Tea YS, Park EY, Kim SH, Kim JE, Kim HY. Cancer nursing: principles and practice. Seoul: Fornurse;2015.

4. Lee HJ, Yang JH. Factors influencing older patients’ participation in decision making regarding cancer surgery. J Korean Gerontol Nurs. 2013; 15:1–10.

5. Meropol NJ, Egleston BL, Buzaglo JS, Benson AB 3rd, Cegala DJ, Dief-enbach MA, et al. Cancer patient preferences for quality and length of life. Cancer. 2008; 113:3459–66.

6. O'Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995; 15:25–30.

7. Whelan T, Levine M, Willan A, Gafni A, Sanders K, Mirsky D, et al. Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial. JAMA. 2004; 292:435–41.

8. Leighl NB, Shepherd HL, Butow PN, Clarke SJ, McJannett M, Beale PJ, et al. 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. 2011; 29:2077–84.

9. Stiggelbout AM, de Haes JC, Kiebert GM, Kievit J, Leer JW. Tradeoffs between quality and quantity of life development of the QQ Questionnaire for Cancer Patient Attitudes. Med Decis Making. 1996; 16:184–92.

10. Voogt E, van der Heide A, Rietjens JA, van Leeuwen AF, Visser AP, van der Rijt CC, et al. Attitudes of patients with incurable cancer toward medical treatment in the last phase of life. J Clin Oncol. 2005; 23:2012–9.

11. Weeks JC, Catalano PJ, Cronin A, Finkelman MD, Mack JW, Keating NL, et al. Patients’ expectations about effects of chemotherapy for advanced cancer. N Engl J Med. 2012; 367:1616–25.

12. Kim BK, Hwang SK. Attitudes toward treatment and decisional conflict in cancer patients receiving chemotherapy in Korea. JKDAS. 2016; 18:1829–44.

13. Elwyn G, Hutchings H, Edwards A, Rapport F, Wensing M, Cheung WY, et al. The OPTION scale: measuring the extent that clinicians in-volve patients in decision-making tasks. Health Expect. 2005; 8:34–42.

14. Pinquart M, Duberstein PR. Information needs and decision-making processes in older cancer patients. Crit Rev Oncol Hematol. 2004; 51:69–80.

15. Mandelblatt J, Kreling B, Figeuriedo M, Feng S. What is the impact of shared decision-making on treatment and outcomes for older women with breast cancer? J Clin Oncol. 2006; 24:4908–13.

16. Park YJ. Uncertainty, anxiety and social support among preoperative patients of cancer: a correlational study [dissertation]. Seoul: Seoul National Univ.;2015.

17. Min HS, Park SY, Lim JS, Park MO, Won HJ, Kim JI. A study on behaviors for preventing recurrence and quality of life in breast cancer survivors. J Korean Acad Nurs. 2008; 38:187–94.

18. Miu AC, Heilman RM, Houser D. Anxiety impairs decision-making: psychophysiological evidence from an Iowa Gambling Task. Biol Psychol. 2008; 77:353–8.

19. Yoon YS, Kim MH, Park JH. Perception of shared decision-making and conflict decision-making related to surgery in elderly patients with cancer. J Korean Gerontol Nurs. 2014; 16:266–75.

20. Kim GD, Jang HJ. Effects of pain, sleep disturbance, and fatigue on the quality of life in patients with pancreatic cancer undergoing chemotherapy. Asian Oncol Nurs. 2012; 12:117–24.

21. Lee EJ, Lee JH. Relationship between health belief, hysterectomy related knowledge and conflict of decision-making in women decisioned hysterectomy. Journal of Wholistic Nursing Science. 2014; 7:207–19.

22. Lee SM, Kim SY, Lee HS. The process of medical decision-making for cancer patients. Korean J Med Ethics. 2009; 12:1–14.

23. Kim OK. Decisional conflict of women who had hysterectomy by benign uterine disease [dissertation]. Seoul: Hanyang Univ.;2010.

24. Kriston L, Scholl I, Hölzel L, Simon D, Loh A, Härter M. The 9-item Shared Decision Making Questionnaire (SDM-Q-9). Development and psychometric properties in a primary care sample. Patient Educ Couns. 2010; 80:94–9.

25. Díaz-Guerrero R, Spielberger CD. Cross-cultural anxiety. Washington, D.C.: Hemisphere Publishing Corporation. 1976.

26. Kim JT, Shin DG. A study based on the standardization of the STAI for Korea. New Med J. 1978; 21:69–75.

27. Baek SK, Kim SY, Heo DS, Yun YH, Lee MK. Effect of advanced cancer patients’ awareness of disease status on treatment decisional conflicts and satisfaction during palliative chemotherapy: a Korean prospective cohort study. Support Care Cancer. 2012; 20:1309–16.

28. Suh WS, Lee CK. Impact of shared-decision making on patient satisfaction. J Prev Med Public Health. 2010; 43:26–34.

29. Stiggelbout AM, Jansen SJ, Otten W, Baas-Thijssen MC, van Slooten H, van de Velde CJ. How important is the opinion of significant others to cancer patients’ adjuvant chemotherapy decision-making? Support Care Cancer. 2007; 15:319–25.