Decision Regret Research Articles

Abstract B102: Impact of previous genetic counseling and reaction to genetic test results among Hispanic/Latino colorectal cancer patients in ENLACE: A cancer Moonshot study

Abstract Background: Inequities in access to genetic testing exist among Hispanic/Latino (H/L) individuals, a population disproportionately affected by colorectal cancer (CRC) burden. Past studies demonstrate the value of genetic counseling (GC) on improving patient understanding of genetic testing utility, but few studies have focused on H/L individuals. Therefore, we assessed the impact of having prior-GC on genetic testing knowledge among patients enrolled in the ENLACE study, a NCI-Moonshot-funded study of participant engagement in genomic characterization among H/L CRC patients. Methods: The ENLACE study enrolled participants from two healthcare facilities since 2022: Los Angeles General Medical Center (LA Gen, a safety-net hospital) and USC Norris Comprehensive Cancer Center (Norris, a university medical center). Baseline surveys to assess sociodemographic characteristics, genetic literacy and comprehension (GLAC), and genetic knowledge (KnowGene) were evaluated. Following somatic and germline return-of-results (ROR), Feelings About genomiC Testing Results (FACToR) for germline sequencing, the impact of somatic testing on cancer patient knowledge, attitudes, and expectations, and Decisional Regret for genomics research participation were evaluated. Results: A total of 105 H/L CRC participants completed surveys at baseline, and 39 post ROR. Most were recruited at LA Gen (n = 72), are male (n = 56), and Mexico-born (n = 55). Fifty participants (33, LA Gen; 17, Norris) had GC prior to study enrollment. No difference was found in the sociodemographic characteristics of participants with prior-GC by facility (p = 0.24). When stratified by prior-GC and facility there were no differences in GLAC and KnowGene scores, using univariate analysis (all p-values > 0.05). Post-ROR total FACToR score, which ranges from 0-48 with higher scores indicating greater functional impairment, was low with a median of 11 (IQR = 5.0-23.0) and no differences were seen for prior-GC or without (p = 0.2). Participants had low decisional regret with a median score of 2.5 (IQR = 0-25.0), on a 0-100 scale. When examining opinions about genetic testing in cancer care, 84% (n = 33) of patients agreed or strongly agreed that genetic testing based on today’s technology would significantly improve their cancer treatment and care. Conclusion: There was no association with prior-GC and baseline genetic knowledge scores. Post-ROR, the cohort had low functional impairment and decisional regret from genetic testing, suggesting that these H/L patients have a favorable reaction to their genetic test results. A limitation of this evaluation is that it does not consider the effect of GC during ROR, completed for some patients, on post-ROR responses. As the study progresses, larger numbers will allow us to stratify by germline test results and dosage of GC. These findings support the need for impactful genetics education tools and communication methods to ensure greater understanding of genetics for H/L individuals to maximize genetic testing utility. Citation Format: Natalia Gutierrez, Joel Sanchez Mendez, Julie O. Culver, Charite R. Ricker, Carmen Chavez, Lucia Enriquez, Sandra Algaze, John D. Carpten, Heinz-Josef Lenz, Mariana C. Stern. Impact of previous genetic counseling and reaction to genetic test results among Hispanic/Latino colorectal cancer patients in ENLACE: A cancer Moonshot study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B102.

“I've been really happy since I got that letter!”: Longitudinal patient perspectives on lung cancer screening communication

ObjectiveExperts recommend structured shared decision making when discussing lung cancer screening (LCS) and reporting low-dose computed tomography (LDCT) results. We examined patients' reactions to pre- and post-LDCT results communication processes at three medical centers in the US with established LCS programs. MethodsMulticenter, qualitative, longitudinal study of patients considering and receiving LCS using data from semi-structured interviews guided by a patient-centered communication model using conventional content analysis. We conducted 61 interviews among 32 patients (sixteen of whom had a nodule on their LDCT) at one month and 12 months after an initial LCS decision making interaction. ResultsParticipants were mostly satisfied with LCS communication processes pre- and post-LDCT even though guideline concordant shared decision making was rare. Most participants reported no more than mild distress even if the LDCT detected a pulmonary nodule, felt relief after getting the results, and reported the perceived benefits of LCS outweighed their distress. Nearly all participants were satisfied with recommended follow-up plans. They reported that they trusted their clinicians and health care system to provide appropriate care and recommendations. They did not appear to regret their decision since almost all participants planned to get their next LDCT. However, they were at risk of non-adherence to follow-up recommendations since they often relied on the health care system to ensure they received timely follow-up. ConclusionsDespite receiving guideline discordant decision-making communication, patients seem very satisfied, rarely experience severe distress, and have low decisional regret after LCS decision making and receiving the results of their LDCT.

Empowering patients: leveraging the untapped potential of smartphone recordings in dermatology consultations.

During consultations, patients can be overwhelmed with new diagnoses, complex treatment plans, particularly when bad news is broken (such as a new skin cancer diagnosis). Patients may be unable to recall nuanced medical information, particularly if elderly, attending on their own, with lower literacy, with impaired sensory abilities and where English may not be their native language. Given the ubiquity of smartphones, recording conversations during consultations—with the doctor’s consent—has become an accessible tool for patients. Allowing patients to record their consultations can empower them, enhance recall, and reduce decisional regret, particularly in emotionally charged settings such as skin cancer clinics where cognitive processing may be impaired.

Decision Regret and Vaccine Hesitancy among Nursing Students and Registered Nurses in Italy: Insights from Structural Equation Modeling.

This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R2 = 31.3%) and Concerns (R2 = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R2 = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance.

The experience of transfeminine adolescents and their parents regarding fertility preservation via testicular sperm extraction (TESE): a qualitative study.

How do transfeminine adolescents and their parents experience fertility preservation via testicular sperm extraction (TESE)? Participants experienced the TESE process positively when provided with appropriate guidance to navigate the decisional dilemma between preserving future biological parenthood and the pressure to start puberty suppression early. Sperm banking through ejaculation is not feasible for all transfeminine adolescents due to genital dysphoria and early puberty; for this group, TESE is the only alternative. However, during early puberty, they must postpone or pause puberty suppression until spermatogenesis is fully developed. All consecutive TESE patients in our centre and their parents were invited to participate. Between December 2022 and May 2023, we included 6 adolescents and 10 parents. We used a qualitative approach based on semi-structured interviews to study the experience of the transfeminine adolescents and their parents. Transfeminine adolescents diagnosed with gender dysphoria in early puberty (Tanner stage ≥2) who underwent TESE before the start of puberty suppression or gender-affirming hormones participated in this study. The interviews were recorded, manually transcribed and analysed using reflective thematic analysis focusing on understanding the participants' experiences of puberty and fertility preservation and the various factors and social processes influencing their decision to undergo TESE. Transfeminine adolescents decide to undergo invasive fertility preservation because of a possible, future desire for parenthood. Parents stressed the importance of preventing future decisional regret. They both saw masturbation to obtain a semen sample as unreachable. Even though TESE is a surgical procedure with possible complications and pain afterwards, this alternative seemed less dysphoric to them.Adolescents had to postpone the start of puberty suppression, waiting for spermatogenesis to complete. Given the unpredictable development of puberty, they felt a lot of stress and anxiety during this period and were primarily concerned about the lowering of their voice. Because of this puberty-related stress, they were constantly balancing their motivations for fertility preservation against the early start of puberty suppression to prevent unwanted irreversible pubertal body changes. To support this decisional dilemma, adolescents and their parents need adequate communication with each other and their healthcare providers to reflect on their stress for pubertal change. Furthermore, close, continuous surveillance of their current mental state by their parents, together with their psychologist and pubertal development by their physicians, is needed. Despite the challenging decision and postponement of puberty suppression, they retrospectively experienced it positively without any regret. All adolescents successfully underwent TESE, with viable spermatozoa obtained and without complications. This may result in a more positive reflective experience regarding fertility preservation. Furthermore, the perspectives of adolescents with the intention of TESE but who already started with puberty suppression before the preservation were not included. This study helps healthcare providers improve their counselling and guidance of transfeminine adolescents who consider postponing puberty suppression for fertility preservation via TESE. The adolescents and their parents know more clearly what to expect during fertility preservation. Specific peer-support programs may facilitate the decision process for upcoming adolescents. No external funding was used for this study. None of the authors have any conflicts of interest. Not applicable.

Artificial-Intelligence Cloud-Based Platform to Support Shared Decision-Making in the Locoregional Treatment of Breast Cancer: Protocol for a Multidimensional Evaluation Embedded in the CINDERELLA Clinical Trial.

Shared decision-making (SDM) plays a crucial role in breast cancer care by empowering patients and reducing decision regret. Patient decision aids (PtDAs) are valuable tools for facilitating SDM, now available in digital and artificial intelligence (AI)-powered formats to offer increasingly personalized contents. The ongoing CINDERELLA clinical trial (ClinicalTrials.gov: NCT05196269) evaluates an innovative AI cloud-based approach using a web platform and a mobile application (CINDERELLA APProach) versus the conventional approach to support SDM in breast cancer patients undergoing locoregional treatment. This protocol outlines a trial-based multidimensional evaluation, encompassing economic, financial, implementability, and environmental considerations associated with the CINDERELLA APProach. A within-trial cost-consequence and cost-utility analysis from a societal perspective will be performed using patient-level data on outcomes and resource use. The latter will be valued in monetary terms using country-specific unit costs or patient valuations. A budget impact analysis will be performed over 1 and 5 years from the budget holder perspectives. The CINDERELLA APProach implementability will be assessed through an evaluation of its usability, acceptability, organizational impact, and overall feasibility. The environmental impact will be quantitatively assessed across several dimensions, such as quantity, appropriateness, and emissions, supplemented by qualitative insights. Overall, data for the evaluation will be gathered from patient questionnaires, interviews with patients and managers, focus groups with healthcare professionals, and app electronic data. A thorough understanding of the broad consequences of the CINDERELLA APProach may foster its successful translation into real-world settings, hopefully benefiting breast cancer patients and clinical practice.

ASO Author Reflections: A Focus on Patient-Reported Outcomes Using Decision Regret in Cytoreductive Surgery and HIPEC.

ASO Author Reflections: A Focus on Patient-Reported Outcomes Using Decision Regret in Cytoreductive Surgery and HIPEC.

The relationship of decision regret with quality of life and comfort level in patients undergoing laparoscopic sleeve gastrectomy: a cross-sectional study

BackgroundLaparoscopic sleeve gastrectomy (SG) is one of the effective methods of weight loss. It is essential to determine patients' regret and predictive factors to improve their quality of life and comfort. No study has investigated decision regret and affecting factors in patients undergoing SG in Turkey. ObjectivesThe study aimed to determine the relationship of decision regret with quality of life and comfort level in patients undergoing SG. SettingThe research was carried out with patients who had undergone SG in a private hospital in the west of Turkey. MethodsThe research was conducted as a descriptive, correlational, and cross-sectional study. Data were collected between March and May 2023, and the study was completed with 286 patients. Data were collected using the Personal Information Form, Decision Regret Scale (DRS), Quality of Life Following Obesity Surgery Scale (QoL-OS), and Comfort Scale. ResultsPatients’ mean score on the DRS was 5.27 ± 13.41 (0-100), the total mean score on the QoL-OS-Biopsychosocial dimension was 79.57 ± 9.35 (18-90), the mean score on the QoL-OS-Complications dimension was 17.17 ± 4.60 (7-35), and the environmental comfort score average was 8.87 ± 2.23 (0-10). Patients’ decision regret was significantly affected by the QoL-OS-Biopsychosocial Area dimension in the first place (Beta = −.516; P < .001), social comfort in the second place (Beta = −.278; P < .001), postoperative weight gain in the third place (Beta = .221; P < .001), and complication development in the fourth place (Beta = .163; P < .001). ConclusionsThe study revealed that patients’ decision regret levels were very low up to 3 years after surgery and found that low postoperative quality of life and social comfort level, postoperative weight gain, and complications affected decision regret.

The Effect of Shared Decision-making on Decision Self-efficacy and Decisional Conflict of Women with Low-grade Squamous Intraepithelial Lesion in Cervical Cytology: An Experimental Study

Background: Women often face decisional challenges and hesitation while choosing the appropriate method to follow up on their abnormal results of cervix cytology. Objective: The present study aimed to determine the effect of shared decision-making (SDM) on decision self-efficacy (DSE) and decisional conflict (DC) about follow-up methods among women with abnormal cervix cytology results. Methods: This interventional study was performed on 54 women referred to the subspecialty clinic of gynecologic oncology. The women were assigned into intervention and control groups using a randomized block design with block sizes of 4 and 6 and an allocation ratio of 1:1. The intervention group received counseling based on the SDM and a decision aid (DA) booklet. The data collection tools included the questionnaires of the demographic and obstetrics characteristics, DC, DSE, and Decision Regret. The collected data were analyzed using SPSS24 software, and independent t-tests and ANCOVA were used. Results: After the intervention, the total mean score of the DC in the intervention group was significantly lower than that in the control group [MD: -22.84 with 95% CI: -23.52 to -21.95, (P &lt;0.001)]. The mean score of DSE in the intervention group was significantly higher than that in the control group [MD: 14.56 with 95% CI: 21.47 to 7.65, (P &lt;0.001)]. Conclusion: The present study results indicated that counseling based on the SDM effectively promotes DSE and reduces DC among women with minor abnormal cervical cytology. Therefore, it is recommended that healthcare providers use SDM for women with abnormal cervical cancer screening results.

Assessing Decision Regret for Active Surveillance versus Surgery in Patients with Low-Risk Papillary Thyroid Cancer

Assessing Decision Regret for Active Surveillance versus Surgery in Patients with Low-Risk Papillary Thyroid Cancer

1102: Decision Regret after Radiotherapy of Oligometastatic Prostate Cancer Patients

1102: Decision Regret after Radiotherapy of Oligometastatic Prostate Cancer Patients

942: Decision regret after radiotherapy – A cross-sectional study in a broad spectrum of cancer patients

942: Decision regret after radiotherapy – A cross-sectional study in a broad spectrum of cancer patients

Decision Regret in Patients with Appendiceal Cancer Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Decision regret is an emerging patient reported outcome. The aim of this study was to assess the incidence of regret in patients with appendiceal cancer (AC) who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). An anonymous survey was distributed to patients through the Appendix Cancer and Pseudomyxoma Peritonei (ACPMP) Research Foundation. The Decision Regret Scale (DRS) was employed, with DRS > 25 signifying regret. Patient demographics, tumor characteristics, postoperative outcomes, symptoms (FACT-C), and PROMIS-29 quality of life (QoL) scores were compared between patients who regretted or did not regret (NO-REG) the procedure. A total of 122 patients were analyzed. The vast majority had no regret about undergoing CRS-HIPEC (85.2%); 18 patients expressed regret (14.8%). Patients with higher regret had: income ≤ $74,062 (72.2% vs 44.2% NO-REG; p = 0.028), major complications within 30 days of surgery (55.6% vs 15.4% NO-REG; p < 0.001), > 30 days hospital stay (38.9% vs 4.8% NO-REG; p < 0.001), a new ostomy (27.8% vs 7.7% NO-REG; p = 0.03), >1 CRS-HIPEC procedure (56.3% vs 12.6% NO-REG; p < 0.001). Patients with worse FACT-C scores had more regret (p < 0.001). PROMIS-29 QOL scores were universally worse in patients with regret. Multivariable analysis demonstrated > 30 days in the hospital, new ostomy and worse gastrointestinal symptom scores were significantly associated with regret. The majority of patients with AC undergoing CRS-HIPEC do not regret undergoing the procedure. Lower income, postoperative complications, an ostomy, undergoing > 1 procedure, and with worse long-term gastrointestinal symptoms were associated with increased regret. Targeted perioperative psychological support and symptom management may assist to ameliorate regret.

Fear of cancer recurrence in breast cancer survivors carrying a BRCA1 or 2 genetic mutation : a cross-sectional study

BackgroundFear of cancer recurrence (FCR) affects virtually all patients who have been treated for cancer, to varying degrees. Breast cancer survivors who carry a BRCA1 or BRCA2 gene mutation are at high risk of cancer recurrence. No study has yet assessed FCR specifically in this population.ObjectivesThis cross-sectional study, conducted in women who were treated for breast cancer and carrying a BRCA1/2 mutation, aimed to: (1) assess the mean level of FCR and estimate the proportion of patients with clinical levels of FCR; (2) examine the relationships between FCR and selected psychological variables (e.g., avoidance, intolerance to uncertainty) and quality of life; (3) explore whether FCR levels vary as a function of the past preventive treatment received; and (4) to assess the associations between FCR and the presence of decisional conflict or regret regarding the various preventive options.MethodParticipants were recruited through an e-mail sent to an oncogenetic network mailing list (Réseau ROSE). Participants were asked to complete a battery of questionnaires online assessing FCR and other psychological and quality of life variables.ResultsA total of 89 women completed the survey. Most participants had undergone a preventive mastectomy (62.9%) and a preventive salpingo-oophorectomy (75.3%) at the time of the study. The mean Fear of Cancer Recurrence Inventory-severity score was 16.8, which exceeds the clinical cut-off score of 13, and 70.8% of the participants showed a clinical level of FCR. FCR was significantly associated with higher levels of anxiety and depression, and higher avoidance and intolerance of uncertainty, but not with quality of life. No significant difference was observed on the total FCR score between women who had received preventive surgery (mastectomy and/or salpingo-oophorectomy) and those considering it, and those not considering it. The association was significant between higher FRC scores and greater decisional conflicts and regrets about choosing to undergo preventive surgery.ConclusionThese data suggest that FCR is a significant problem for breast cancer survivors carrying a BRCA1/2 genetic mutation, even after undergoing a prophylactic surgery. This highlights the importance of providing these women with specific psychological intervention focusing on FCR.

Do Difficulties in Career Affect Life Satisfaction? Examining the Relationships Between Life Satisfaction, Career Decision Regret, and Career Distress

Life satisfaction, which is an important indicator of the well-being and happiness of individuals, can be affected by different development areas of the individual. On this basis, the experiences of individuals regarding their career development processes may also have an impact on life satisfaction. In the current study, which was carried out to test this, the mediating role of career distress in the relationship between individuals' career decision regret and life satisfaction was examined. The current study was carried out with 321 university students. The ages of the participants ranged from 18 to 26, with an average age of 20.78 years. The Career Decision Regret Scale, The Career Distress Scale, and The Satisfaction with Life Scale were used to collect data. The analysis of the data was made with the structural equation modeling method. The results revealed that life satisfaction is negatively related to both career decision regret and career distress. Another important finding is that career distress has a fully mediating role in the relationship between career decision regret and life satisfaction. The findings were discussed based on the relevant literature, and suggestions were presented regarding the results.

Evaluating decision regret after extremely preterm birth

ObjectivesLittle is known about decision regret following extremely premature birth. We assessed decision regret in women who delivered an extremely premature infant, comparing decision regret scores based on resuscitation decision.MethodsElectronic...

Prenatal Screening of Chromosomal Anomalies Using Genome-Wide or Target Cell-Free DNA: Preferences and Satisfaction of Pregnant Women.

Background/Objectives: Cell-free DNA (cfDNA) is a non-invasive prenatal test used to screen for common trisomies (target cfDNA) that can be expanded to assess all autosomal chromosomes (genome-wide cfDNA). As cfDNA testing gains popularity, it is crucial to examine the factors influencing the decision-making process of pregnant individuals when choosing between these two approaches. Methods: In this prospective cohort study, 190 individuals undergoing cfDNA testing for aneuploidy screening, according to the current screening protocol, were allowed to make their own choice between target and genome-wide cfDNA testing. They were asked to complete a first survey at 11-13 weeks, designed to explore their characteristics, preferences, and satisfaction with the prenatal genetic counseling session, as well as a Decisional Conflict Scale. A postnatal survey was administered three months after delivery, including the Decisional Regret Scale and two open questions. Results: 84% of participants opted for genome-wide cfDNA. However, 17% found the decision challenging, and 14% felt that the results might increase anxiety. No significant differences in participant characteristics were found when comparing decisions between genome-wide and target cfDNA. However, significant differences were observed regarding ethnicity (p = <0.001), educational level (p = 0.029), previous cfDNA experience (p = 0.004), and having sufficient information when comparing termination options (p = 0.002). After delivery, only 4% would have changed their decision. Conclusions: Individuals, regardless of their characteristics, prefer genome-wide cfDNA; however, the complexity of the results necessitates enhanced genetic education for prenatal care clinicians.

Caregiver decisional regret following reconstructive bladder surgery in children with neurogenic bladder

Surgical management for neurogenic bladder requires complex decision-making by physicians, patients, and caregivers. Assessing decisional regret (DR) as a patient-reported outcome among caregivers could inform future counseling and shared decision-making. To assess DR among caregivers of children with neurogenic bladder following reconstructive bladder surgery. A questionnaire including a validated DR survey was distributed to English-speaking caregivers of children with neurogenic bladder who had undergone reconstructive bladder surgery at Children's Hospital Colorado. DR scores range from zero to 100, with higher numbers indicating higher regret. Wilcoxon rank sum test and Spearman correlation were performed to assess differences in DR scores by patient demographic factors or disease factors. Forty-five of 210 English-speaking caregivers completed the DR survey. The median DR score was 5, with 40% of subjects reporting with a DR score of zero and 24% of subjects with a DR score of 30 or higher. Patient sex and Mitrofanoff leakage were found to be associated with DR, with caregivers of male patients reporting significantly higher DR. Surgical procedure did not have a statistically significant impact on DR scores. Sparse existing data exploring DR among patients with neurogenic bladder suggest DR following reconstructive bladder surgery is low, with few identifiable predictors of regret. While the majority of caregivers in our study report little or no DR, one quarter of caregivers report moderate to high DR. The limitations of this study include small cohort size, low response rate, exclusion of non-English speaking patients, and the potential for recall bias due to the survey design of the study. Caregiver DR following bladder reconstruction in children with neurogenic bladder is generally low, however a subset of caregivers reports significant DR. This study suggests that caregivers of male children may have higher DR, a finding that merits further investigation.

Longitudinal Assessment of Communication With Patient-Reported Outcomes During Lung Cancer Screening

BackgroundMany organizations recommend clinicians use structured communication processes, referred to as “shared decision making,” to improve patient-reported outcomes for patients considering lung cancer screening (LCS). Research QuestionWhich components of high-quality patient-centered communication are associated with decision regret and distress? Study Design and MethodsWe conducted a prospective, longitudinal, repeated measures, cohort study among patients undergoing lung cancer screening in three different healthcare systems. We surveyed participants using validated measures of decision regret, decision satisfaction, distress, and patient-clinician communication domains up to a year after the low-dose computed tomography (LDCT) for LCS. For longitudinal analyses, we applied a series of generalized estimating equations to measure the association of the “patient as person” communication domain, screening knowledge, and decision concordance with decision regret and distress. ResultsWhen assessed 2-4 weeks after the LDCT, 202 (58.9%) and 8 (2.3%) of 343 total respondents reported mild and moderate/severe decision regret, respectively, while 29 (9.2%) participants of 315 total reported mild distress and 19 (6.0%) moderate or greater distress. The mean ± SD decision satisfaction scores (0 to 10 scale) were 9.82 ± 0.89, 9.08 ± 1.54, and 6.13 ± 3.40 among those with no, mild, and moderate/severe regret respectively. Distress scores remained low after the LDCT, even among those with nodules. Patient-centered communication domains were not associated with decision regret or distress. InterpretationPatients undergoing LCS rarely experience moderate or greater decision regret and distress. Although many participants reported mild decision regret, most were very satisfied over the year after their LDCT for LCS. Communication processes were not associated with regret and distress, suggesting that it may be challenging for communication interventions to reduce the harms of LCS.

Shared decision‐making, treatment decision regret, and vision-related quality of life among parents of children with myopia: An online survey in Taiwan

ObjectivesTo investigate the relationships among myopia treatment, decision regret, shared decision-making, and vision-related quality of life among parents of 6–12-year-old children with myopia. MethodsAn online Google Forms questionnaire was developed using a cross-sectional design and distributed between January 16 and August 22, 2023. Parents of 6–12-year-old children with myopia were recruited through school nurses working in Taiwan. The children’s and parents’ demographic data were collected. Study instruments included the Decisional Regret Scale, Shared Decision‐Making, and Vision-Related Quality of Life questionnaires. Multivariable linear regression analysis was used to identify factors influencing vision-related quality of life. ResultsOf 350 parents contacted, 314 questionnaires were analyzed. Among the respondents, 77.39 % (n = 243) were mothers, and most were aged >40 years. The mean age of children at myopia diagnosis was 7.12 ± 1.24 years; 46.50 % had < − 1.0 diopters of refractive error. Atropine eye drops were the primary treatment; 17.71 % of children were prescribed orthokeratology for myopia control. Parents reported low levels of decision regret and moderate levels of shared decision-making and vision-related quality of life. Children’s age, use of orthokeratology lenses, decision regret, and shared decision-making significantly influenced the vision-related quality of life reported by the parents, accounting for 22.5 % of the variance. ConclusionThe study’s findings emphasize the importance of addressing decision regret and promoting shared decision-making in myopia treatment. Eye care professionals should discuss treatment options thoroughly before making decisions. Through shared decision-making, parents can make informed choices about treatments based on a comprehensive understanding of the benefits and drawbacks, ultimately benefitting children’s vision health.