A video decision aid improves informed decision-making in patients with advanced cancer considering palliative radiation therapy

AbstractContextAdvanced cancer patients have unrecognized gaps in their understanding about palliative radiation therapy (PRT). ObjectivesTo build a video decision aid for hospitalized patients with advanced cancer referred for PRT and prospectively test its efficacy in reducing decisional uncertain...

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Bibliographic Details
Published in:Journal of pain and symptom management 2019-12, Vol.58 (6), p.1048-1055.e2
Main Authors: Dharmarajan, Kavita V, Walters, Chasity B, Levin, Tomer T, Milazzo, Carol Ann, Monether, Christopher, Rawlins-Duell, Robin, Tickoo, Roma, Spratt, Daniel E, Lovie, Shona, Giannantoni-Ibelli, Gina, McCormick, Beryl
Format: Article
Language:English
Subjects:
Adult
advanced cancer
Aged
Anesthesia
Cancer
Cancer therapies
Clinical decision making
Clinical Decision-Making - methods
decision aid
Decision making
Efficacy
Female
Hospice care
Hospitalization
Hospitalized
Humans
Male
Middle Aged
Neoplasms - radiotherapy
Pain Medicine
Palliative care
Palliative Care - methods
Palliative radiation therapy
Patient Acceptance of Health Care
Patient Education as Topic
Patient Satisfaction
Patients
Polls & surveys
Prospective Studies
Radiation
Radiation therapy
Referral and Consultation
Surveys and Questionnaires
Treatment Outcome
Uncertainty
video tool
Viewers
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Summary:AbstractContextAdvanced cancer patients have unrecognized gaps in their understanding about palliative radiation therapy (PRT). ObjectivesTo build a video decision aid for hospitalized patients with advanced cancer referred for PRT and prospectively test its efficacy in reducing decisional uncertainty, improving knowledge, increasing treatment readiness and readiness for palliative care consultation, and its acceptability among patients. MethodsForty patients with advanced cancer hospitalized at Memorial Sloan Kettering Cancer Center watched a video decision aid about PRT and palliative care. Patients’ conceptual and logistical knowledge of PRT, decisional uncertainty, treatment readiness, and readiness for palliative care consultation were assessed before and after watching the video with a 6-item knowledge survey, the decisional uncertainty subscale of the Decisional Conflict Scale, and Likert instruments to assess readiness to accept radiation treatment and/or palliative care consultation, respectively. A post-video survey assessed the video’s acceptability among patients. ResultsAfter watching the video, decisional uncertainty was reduced (28.3 vs. 21.7, p=0.02); knowledge of PRT improved (60.4 vs. 88.3, p
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2019.08.014