BMC Med Inform Decis Mak - Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol.

Tópicos

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Resumo

CKGROUND: There is a continuing debate on the desirability of informing patients with cancer and thereby involving them in treatment decisions. On the one hand, information uptake may be hampered, and additional stress could be inflicted by involving these patients. On the other hand, even patients with advanced cancer desire information on risks and prognosis. To settle the debate, a decision aid will be developed and presented to patients with advanced disease at the point of decision making. The aid is used to assess the amount of information desired. Factors related to information desire are explored, as well as the ability of the medical oncologist to judge the patient's information desire. The effects of the information on patient well-being are assessed by comparing the decision aid group with a usual care group.METHODS/DESIGN: This study is a randomized controlled trial of patients with advanced colorectal, breast, or ovarian cancer who have started treatment with first-line palliative chemotherapy. The trial will consist of 100 patients in the decision aid group and 70 patients in the usual care group. To collect complete data of 170 patients, 246 patients will be approached for the study. Patients will complete a baseline questionnaire on sociodemographic data, well-being measures, and psychological measures, believed to predict information desire. The medical oncologist will judge the patient's information desire. After disease progression is diagnosed, the medical oncologist offers the choice between second-line palliative chemotherapy plus best supportive care (BSC) and BSC alone. Randomization will take place to determine whether patients will receive usual care (n = 70) or usual care and the decision aid (n = 100). The aid offers information about the potential risks and benefits of both treatment options, in terms of adverse events, tumour response, and survival. Patients decide for each item whether they desire the information or not. Two follow-up questionnaires will evaluate the effect of the decision aid.DISCUSSION: This study attempts to settle the debate on the desirability of informing patients with cancer. In contrast to several earlier studies, we will actually deliver information on treatment options to patients at the point of decision making.

Resumo Limpo

ckground continu debat desir inform patient cancer therebi involv treatment decis one hand inform uptak may hamper addit stress inflict involv patient hand even patient advanc cancer desir inform risk prognosi settl debat decis aid will develop present patient advanc diseas point decis make aid use assess amount inform desir factor relat inform desir explor well abil medic oncologist judg patient inform desir effect inform patient wellb assess compar decis aid group usual care groupmethodsdesign studi random control trial patient advanc colorect breast ovarian cancer start treatment firstlin palliat chemotherapi trial will consist patient decis aid group patient usual care group collect complet data patient patient will approach studi patient will complet baselin questionnair sociodemograph data wellb measur psycholog measur believ predict inform desir medic oncologist will judg patient inform desir diseas progress diagnos medic oncologist offer choic secondlin palliat chemotherapi plus best support care bsc bsc alon random will take place determin whether patient will receiv usual care n usual care decis aid n aid offer inform potenti risk benefit treatment option term advers event tumour respons surviv patient decid item whether desir inform two followup questionnair will evalu effect decis aiddiscuss studi attempt settl debat desir inform patient cancer contrast sever earlier studi will actual deliv inform treatment option patient point decis make

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