title: Predictors of satisfaction with treatment decision, decision-making preferences, and main treatment goals in patients with advanced cancer.
abstract: OBJECTIVE
  This study investigated satisfaction with treatment decision (SWTD), decision-making preferences (DMP), and main treatment goals, as well as evaluated factors that predict SWTD, in patients receiving palliative cancer treatment at a Swiss oncology network.
  
  
  METHODS
  Patients receiving a new line of palliative treatment completed a questionnaire 4-6 weeks after the treatment decision. Patient questionnaires were used to collect data on sociodemographics, SWTD (primary outcome measure), main treatment goal, DMP, health locus of control (HLoC), and several quality of life (QoL) domains. Predictors of SWTD (6 = worst; 30 = best) were evaluated by uni- and multivariate regression models.
  
  
  RESULTS
  Of 480 participating patients in eight hospitals and two private practices, 445 completed all questions regarding the primary outcome measure. Forty-five percent of patients preferred shared, while 44 % preferred doctor-directed, decision-making. Median duration of consultation was 30 (range: 10-200) minutes. Overall, 73 % of patients reported high SWTD (≥24 points). In the univariate analyses, global and physical QoL, performance status, treatment goal, HLoC, prognosis, and duration of consultation were significant predictors of SWTD. In the multivariate analysis, the only significant predictor of SWTD was duration of consultation (p = 0.01). Most patients indicated hope for improvement (46 %), followed by hope for longer life (26 %) and better quality of life (23 %), as their main treatment goal.
  
  
  CONCLUSIONS
  Our results indicate that high SWTD can be achieved in most patients with a 30-min consultation. Determining the patient's main treatment goal and DMP adds important information that should be considered before discussing a new line of palliative treatment.
authors.affiliation: Department of Medical Oncology/Hematology, Kantonsspital St. Gallen, Rorschacherstrasse, 9007, St. Gallen, Switzerland, felicitas.hitz@bluewin.ch.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Hitz
authors.forename: Karin
authors.initials: K
authors.lastname: Ribi
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Li
authors.forename: Dirk
authors.initials: D
authors.lastname: Klingbiel
authors.forename: Thomas
authors.initials: T
authors.lastname: Cerny
authors.forename: Dieter
authors.initials: D
authors.lastname: Koeberle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003142:Communication; D003657:Decision Making; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires