Abstract
BackgroundIn 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.MethodsIn 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.ResultsExploratory 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).ConclusionFindings 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.
Highlights
The most effective treatment options for curative lung cancer are video assisted thoracoscopic (VATS) resection or stereotactic ablative body radiotherapy (SABR) for patients unfit for surgery
Participant characteristics A total of 244 patients consented to the study of which 158 (64.7%) returned the Decision Self-Efficacy Scale at baseline
We aimed to explore the psychometric properties of the Decision Self-Efficacy scale (DSE) in a cohort of patients undergoing Video-assisted Thoracoscopic Surgery (VATS) resection or Stereotactic Ablative Radiotherapy (SABR) therapy for Non-Small Cell Lung Cancer (NSCLC)
Summary
The most effective treatment options for curative lung cancer are video assisted thoracoscopic (VATS) resection or stereotactic ablative body radiotherapy (SABR) for patients unfit for surgery. About 44% of patients diagnosed with lung cancer are aged 75 and over [5] and commonly have multiple comorbidities with 54% presenting with three or more [6] reducing their eligibility for surgery [6, 7]. This makes the patient’s decision to proceed with one of these treatments more complex, especially for those patients at higher medical risk. 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
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