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

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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.

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Acknowledgments

The authors would like to thank Margit Hemetsberger (Hemetsberger Medical Services, Vienna, Austria), Eva Müller (Lifescience Texte, Vienna, Austria), and Julia Balfour (Northstar Medical Writing and Editing Services, Dundee, UK), who assisted with the preparation of this manuscript and were funded by the Kantonsspital St. Gallen, Switzerland. The authors also thank Ivo Betschard for data preparation, and all patients, oncologists, and nurses at each participating center.

Funding

This study was supported by OSKK (Ostschweizer Stiftung für Klinische Krebsforschung).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medical Oncology/Hematology, Kantonsspital St. Gallen, Rorschacherstrasse, 9007, St. Gallen, Switzerland

    Felicitas Hitz, Thomas Cerny & Dieter Koeberle

  2. International Breast Cancer Study Group, Coordinating Center, Quality of Life Office, Effingerstrasse 58, 3008, Bern, Switzerland

    Karin Ribi

  3. Swiss Group for Clinical Cancer Research, Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland

    Qiyu Li & Dirk Klingbiel

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  1. Felicitas Hitz
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  2. Karin Ribi
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Correspondence to Felicitas Hitz.

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Hitz, F., Ribi, K., Li, Q. et al. Predictors of satisfaction with treatment decision, decision-making preferences, and main treatment goals in patients with advanced cancer. Support Care Cancer 21, 3085–3093 (2013). https://doi.org/10.1007/s00520-013-1886-4

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  • DOI: https://doi.org/10.1007/s00520-013-1886-4

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