Thyroid cancer patients’ involvement in adjuvant radioactive iodine treatment decision-making and decision regret: an exploratory study

• Published in: Supportive care in cancer Vol. 20; no. 3; pp. 641 - 645
• Main Authors: Sawka, A. M., Straus, S., Gafni, A., Meiyappan, S., David, D., Rodin, G., Brierley, J. D., Tsang, R. W., Thabane, L., Rotstein, L., Ezzat, S., Goldstein, D. P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-03-2012; Springer; Springer Nature B.V
• Subjects: Adjuvant treatment; Adolescent; Adult; Cancer; Cancer patients; Cancer therapies; Care and treatment; Decision Making; Emotions; Feasibility Studies; Female; Humans; Iodine Radioisotopes - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Nursing; Nursing Research; Oncology; Pain Medicine; Patient Participation; Patient Satisfaction; Radiotherapy; Radiotherapy, Adjuvant; Rehabilitation Medicine; Short Communication; Surveys and Questionnaires; Thyroid cancer; Thyroid Neoplasms - radiotherapy; Thyroid Neoplasms - surgery; Thyroidectomy; Young Adult; Decision regret; Patient education; Medical decision making; Thyroid carcinoma
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-011-1302-x

Purpose
We explored regret in thyroid cancer patients, relating to the decision to accept or reject adjuvant radioactive iodine treatment.
Methods
We studied patients with a recent diagnosis of early stage papillary thyroid carcinoma, in whom treatment decisions on adjuvant radioactive iodine had been finalized. Participants completed a Decision Regret Scale questionnaire. We asked the participants to identify who made the final decision about radioactive iodine treatment. We explored the relationship between decision regret and a) degree of patient involvement in decision-making and b) receipt of radioactive iodine treatment.
Results
We included 44 individuals, more than half of whom received adjuvant radioactive iodine treatment (26/44). Decision regret was generally low (mean 22.1, standard deviation [SD] 13.0). Participants reported that the final treatment decision was made by the following: patient and doctor (52.3%, 23/44), completely the patient (27.3%, 12/44), or completely the physician (20.5%, 9/44). Decision regret significantly differed according to who made the final decision: the patient (mean 19.0, SD 11.3), patient and doctor (mean 19.5, SD 7.4), and the doctor (mean 32.9, SD 20.37) (
F
 = 4.569; degrees of freedom = 2, 41;
p
 = 0.016). There was no significant difference in decision regret between patients who received radioactive iodine and those who did not (mean difference −2.5; 95% confidence interval −10.6, 5.6;
p
 = 0.540).
Conclusion
Thyroid cancer patients who reported being involved in the final treatment decision on adjuvant radioactive iodine had less regret than those who did not.