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

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.

Self-efficacy of advanced cancer patients for participation in treatment related decision- making: the ACTION study.

“…It is however likely that the associations studied are complex and bidirectional. In addition, it might be useful to understand which aspects of self-e cacy are particularly important in order to actually participate in decision-making [43]. Another limitation of this study relates to the low number of individuals considering themselves part of a minority group within the six countries.…”

“…It is unknown whether the association is due to patients' physical or mental well-being. In a study among patients with lung cancer, poor clinical performance status as assessed by physicians was associated with a lower likelihood among patients to be con dent in making decisions about treatment [43]. In addition, one study showed that a better health status was associated with a higher level of self-e cacy among older persons [14].…”

Factors influencing patient satisfaction after treatments for early-stage non-small cell lung cancer

“…The Decision Self-Efficacy (DSE) scale is an 11-item questionnaire assessing the efficacy of decision-making with a 5-point response scale to generate a score between 0 and 100, with 0 indicating very low decision self-efficacy and 100 indicating very high decision self-efficacy. This instrument was shown to be reliable and valid for use in this population (Pompili et al 2020 ). We administered the DSE at the pre-treatment time point.…”

Impacts of self-confidence cultivation combined with family collaborative nursing on the hope level, stigma and exercise tolerance in patients undergoing radical resection of pulmonary carcinoma

“…Patients undergoing radical resection of pulmonary carcinoma generally lack self-confidence in rehabilitation. Self-confidence cultivation emphasizes comprehensive use of various means to effectively enhance patients' self-confidence in overcoming the disease ( 4 ). Family-based collaborative nursing is a nursing method developed on the basis of responsibility-based nursing, which emphasizes the participation of patients' families in the nursing process ( 5 ).…”