The relationship between role preferences in decision-making and level of psychological distress in patients with head and neck cancer

Joe Jabbour; Haryana M Dhillon; Heather L Shepherd; Puma Sundaresan; Chris Milross; Jonathan R Clark

doi:10.1016/j.pec.2018.05.023

The relationship between role preferences in decision-making and level of psychological distress in patients with head and neck cancer

Patient Educ Couns. 2018 Oct;101(10):1736-1740. doi: 10.1016/j.pec.2018.05.023. Epub 2018 May 28.

Authors

Joe Jabbour¹, Haryana M Dhillon², Heather L Shepherd², Puma Sundaresan³, Chris Milross⁴, Jonathan R Clark⁵

Affiliations

¹ St Vincent's Hospital, Sydney, NSW, Australia; Central Clinical School, University of Sydney, NSW, Australia. Electronic address: joejabbour@icloud.com.
² Psycho-Oncology Cooperative Research Group (POCOG), School of Psychology, The University of Sydney, Camperdown, NSW, Australia; Centre for Medical Psychology & Evidence-Based Decision-making, The University of Sydney, Camperdown, NSW, Australia.
³ Central Clinical School, University of Sydney, NSW, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia.
⁴ Central Clinical School, University of Sydney, NSW, Australia; Department of Radiation Oncology and Medical Services, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
⁵ Central Clinical School, University of Sydney, NSW, Australia; Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; South West Clinical School, University of New South Wales, NSW, Australia.

PMID: 29866431
DOI: 10.1016/j.pec.2018.05.023

Abstract

Objective: Is there a relationship between decision-making preferences and psychological distress?

Methods: Patients who had received treatment for head and neck cancer (HNC) at four institutions within NSW, Australia were invited to complete a single questionnaire.

Results: Five hundred and ninety-seven patients completed the questionnaire. The majority of patients (308, 54%) preferred shared decision making. Significant predictors of a preference towards active decision making were education level (OR 2.1 for tertiary, p < 0.001), primary cancer site (OR 1.9 for thyroid compared to salivary gland, p = 0.024) and gender (OR 1.4 for female, p = 0.028). Mean psychological distress score on Kessler 6 (K6) was 9 (Range: 0-28). Significant predictors of psychological distress were age (p < 0.001), gender (p < 0.001), primary site (p < 0.01), and decision preference (p < 0.01).

Conclusion: HNC patients who are either tertiary educated or female are more likely to prefer active involvement in decision-making. Psychological distress is more likely in patients actively involved in decision making, younger patients, and in females.

Practice implications: Patients experienced paternalistic decision-making, but most preferred active or a shared approached. Clinicians need to be aware of potential for psychological distress in active decision-makers and refer patients for psychosocial support.

Keywords: Decision-making experience; Decision-making preference; Head and neck cancer; Psychological distress.

MeSH terms

Adult
Aged
Aged, 80 and over
Australia
Cross-Sectional Studies
Decision Making*
Female
Head and Neck Neoplasms / psychology*
Head and Neck Neoplasms / therapy
Humans
Male
Middle Aged
Patient Participation / psychology*
Patient Preference / psychology*
Patients / psychology*
Physician-Patient Relations
Stress, Psychological / diagnosis
Stress, Psychological / psychology*
Surveys and Questionnaires