Decision regret following treatment for localized breast cancer: Is regret stable over time?

Martinez, Kathryn A.; Resnicow, Ken; Hawley, Sarah T.

doi:10.1200/jco.2013.31.31_suppl.19

Cited by 13 publications

(48 citation statements)

References 31 publications

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“…The internal consistency was very good and comparable to the one reported for the original DRS (0.81 to 0.84 for people with cancer or patients with cancer) and the one identified in the Japanese validation of the original DRS (0.85) . Reproducibility for the DRS‐C over an average 12‐week period was considerable, indicating reasonable stability over time which corroborates previous findings in a patient sample with localized breast cancer and from a recent systematic review . However, at this point, it remains plausible that regret diminishes over time in many individuals as some authors have argued .…”

Section: Discussionsupporting

confidence: 84%

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Haun

Schakowski

Preibsch

et al. 2019

Health Expectations

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Background Decisional regret during or after medical treatments is linked to significant distress. Regret affects not only patients but also caregivers having an active or passive role during decision making. The Decision Regret Scale (DRS) is a self‐report measure for regret in patients after treatment decisions. However, practical and psychometrically robust instruments assessing regret in caregivers are lacking. Objective To develop and validate a caregiver version of the DRS (Decision Regret Scale for Caregivers [DRS‐C]). Design Psychometric validation based on a web survey. Setting and participants 361 caregivers of deceased German people/patients with cancer. Main variables studied Besides structural validity and test‐retest reliability, we evaluated measurement invariance accounting for gender, age and closeness of relationship, and tested hypotheses on convergent/discriminant validity. Results Forty‐five per cent of all caregivers demonstrated decision regret. Confirmatory factor analyses strongly supported the unidimensional structure of the DRS‐C and pointed to strict invariance. The DRS‐C demonstrated very good internal consistency (α = 0.83, 95% CI [0.81, 0.86]) and test‐retest reliability (ICC [A,1] = 0.73, 95% CI [0.59, 0.83]) along with sound convergent/discriminant validity. Concerning responsiveness, DRS‐C scores remained stable over a 12‐week period in 83.3% of all caregivers. Receiver operating characteristic analysis yielded a cut point of 43 for the identification of significant decision regret (AUC = 0.62, 95% CI [0.56, 0.68]). Discussion and conclusions The lack of a gold standard instrument prevented us from examining the criterion validity and determining a minimally important difference. Nevertheless, the DRS‐C provides valid and reliable information regarding caregiver regret following medical decisions. Above all, it captures a crucial aspect of the treatment experience in caregivers.

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Section: Discussionsupporting

confidence: 84%

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Haun

Schakowski

Preibsch

et al. 2019

Health Expectations

View full text Add to dashboard Cite

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“…Three of the 12 studies did not report on the timing of BR . Three studies reported on IBR only; four on IBR and DBR; one on DBR and NBR; and one on IBR, DBR, and NBR .…”

Section: Resultsmentioning

confidence: 99%

“…Most of the 12 studies used quantitative questionnaires, while only two used qualitative interview techniques . Of the 10 studies using validated questionnaires, one used section 3 of the BREAST‐Q, six used the DRS, and one used a modified version of the DRS; only 4 publications using the DRS provided actual DR scores …”

Section: Resultsmentioning

confidence: 99%

“…The largest stated age range for women was from Sheehan et al's study, which ranged from 24 to 84 years . Of the 11 studies that provided information about ethnicity (all except Brennan et al), two had all Chinese participants, one had all white participants, and the remainder had a majority of participants who were white, including two studies that had deliberately over‐sampled non‐white women …”

Section: Resultsmentioning

confidence: 99%

“…The potentially important DR variable of time between surgery and assessment of DR was difficult to compare across studies. Of the 11 studies that did state a time, two referred to time since mastectomy, four specified a range of times since diagnosis, two specified several time points since initial surgery (either BCS, mastectomy only, or mastectomy with IBR) and 3 discussed time since BR (immediate or delayed) …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Decisional regret and choice of breast reconstruction following mastectomy for breast cancer: A systematic review

2017

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When a Patient Regrets Having Undergone a Carefully and Jointly Considered Treatment Plan, How Should Her Physician Respond?

Selby

Aquina

Pawlik

2020

AMA Journal of Ethics

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Shared decision making is best utilized when a decision is preference sensitive. However, a consequence of choosing between one of several reasonable options is decisional regret: wishing a different decision had been made. In this vignette, a patient chooses mastectomy to avoid radiotherapy. However, postoperatively, she regrets the more disfiguring operation and wishes she had picked the other option: lumpectomy and radiation. Although the physician might view decisional regret as a failure of shared decision making, the physician should reflect on the process by which the decision was made. If the patient's wishes and values were explored and the decision was made in keeping with those values, decisional regret should be viewed as a consequence of decision making, not necessarily as a failure of shared decision making. CaseMs S is a 60-year-old woman with stage I breast cancer. After diagnosis, she was referred to a surgical oncologist, Dr J. Over the course of several visits, Dr J and Ms S considered risks and benefits of 2 primary treatment options: breast-conserving surgery with follow-up radiation and total mastectomy, which generally does not require radiation. The patient and surgeon agreed that a left total mastectomy would be best.The mastectomy went well, and, during a follow-up visit, Dr J reported good news: there was no evidence to suggest that Ms S's cancer had spread beyond her breast. Ms S was pleased to hear this news. She also seemed worried, however. "So, I was reading that there is no difference in survival between breast-conserving surgery and mastectomy." "Yes, you're right. But as we discussed before your surgery, mastectomy patients are less likely to need radiation. 1 You didn't want radiation," Dr J responded.Ms S resumed, "Well, that was what I thought at the time. 2 But now I wish I'd had the breast-conserving therapy with the radiation. Maybe I didn't need the more disfiguring surgery."

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Decision regret following treatment for localized breast cancer: Is regret stable over time?

Abstract: Background-While studies suggest most women have little regret regarding their breast cancer treatment decisions immediately following treatment, to date no studies have evaluated how regret may change over time.

Cited by 13 publications

References 31 publications

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Decisional regret and choice of breast reconstruction following mastectomy for breast cancer: A systematic review

When a Patient Regrets Having Undergone a Carefully and Jointly Considered Treatment Plan, How Should Her Physician Respond?

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