Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study

Anne N Heirman; Daan P de Kort; Japke F Petersen; Abrahim Al-Mamgani; Simone E J Eerenstein; Bertram J de Kleijn; Frank Hoebers; Bernard M Tijink; Martijn M Stuiver; Lisette van der Molen; Richard Dirven; Gyorgy B Halmos; Michiel W M van den Brekel

doi:10.1002/lary.31336

Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study

Anne N Heirman, Daan P de Kort, Japke F Petersen, Abrahim Al-Mamgani, Simone E J Eerenstein, Bertram J de Kleijn, Frank Hoebers, Bernard M Tijink, Martijn M Stuiver, Lisette van der Molen, Richard Dirven, Gyorgy B Halmos, Michiel W M van den Brekel

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors.

METHODS: In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data.

RESULTS: Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0-100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0-100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7).

CONCLUSION: Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling.

LEVEL OF EVIDENCE: Level IV Laryngoscope, 2024.

Original language	English
Journal	Laryngoscope
Early online date	17 Feb 2024
DOIs	https://doi.org/10.1002/lary.31336
Publication status	E-pub ahead of print - 17 Feb 2024

Keywords

counseling
decision-making
decisional conflict
laryngectomy
larynx cancer

Access to Document

10.1002/lary.31336

Cite this

Heirman, A. N., de Kort, D. P., Petersen, J. F., Al-Mamgani, A., Eerenstein, S. E. J., de Kleijn, B. J., Hoebers, F., Tijink, B. M., Stuiver, M. M., van der Molen, L., Dirven, R., Halmos, G. B., & van den Brekel, M. W. M. (2024). Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study. Laryngoscope. Advance online publication. https://doi.org/10.1002/lary.31336

@article{8814feff8af645b78a959b42a8ab7dec,

title = "Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study",

abstract = "OBJECTIVES: Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors.METHODS: In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data.RESULTS: Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0-100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0-100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7).CONCLUSION: Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling.LEVEL OF EVIDENCE: Level IV Laryngoscope, 2024.",

keywords = "counseling, decision-making, decisional conflict, laryngectomy, larynx cancer",

author = "Heirman, {Anne N} and {de Kort}, {Daan P} and Petersen, {Japke F} and Abrahim Al-Mamgani and Eerenstein, {Simone E J} and {de Kleijn}, {Bertram J} and Frank Hoebers and Tijink, {Bernard M} and Stuiver, {Martijn M} and {van der Molen}, Lisette and Richard Dirven and Halmos, {Gyorgy B} and {van den Brekel}, {Michiel W M}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.",

year = "2024",

month = feb,

day = "17",

doi = "10.1002/lary.31336",

language = "English",

journal = "Laryngoscope",

issn = "0023-852X",

publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Decisional Conflict in Patients with Advanced Laryngeal Carcinoma

T2 - A Multicenter Study

AU - Heirman, Anne N

AU - de Kort, Daan P

AU - Petersen, Japke F

AU - Al-Mamgani, Abrahim

AU - Eerenstein, Simone E J

AU - de Kleijn, Bertram J

AU - Hoebers, Frank

AU - Tijink, Bernard M

AU - Stuiver, Martijn M

AU - van der Molen, Lisette

AU - Dirven, Richard

AU - Halmos, Gyorgy B

AU - van den Brekel, Michiel W M

PY - 2024/2/17

Y1 - 2024/2/17

N2 - OBJECTIVES: Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors.METHODS: In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data.RESULTS: Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0-100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0-100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7).CONCLUSION: Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling.LEVEL OF EVIDENCE: Level IV Laryngoscope, 2024.

AB - OBJECTIVES: Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors.METHODS: In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data.RESULTS: Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0-100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0-100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7).CONCLUSION: Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling.LEVEL OF EVIDENCE: Level IV Laryngoscope, 2024.

KW - counseling

KW - decision-making

KW - decisional conflict

KW - laryngectomy

KW - larynx cancer

UR - http://www.scopus.com/inward/record.url?scp=85185684182&partnerID=8YFLogxK

U2 - 10.1002/lary.31336

DO - 10.1002/lary.31336

M3 - Article

C2 - 38366759

SN - 0023-852X

JO - Laryngoscope

JF - Laryngoscope

ER -

Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study

Abstract

Keywords

Access to Document

Other files and links

Cite this