Decision regret regarding treatments among women with early-stage breast cancer: a systematic review protocol

Liu, Jing; Hunter, Sharyn; Zhu, Jiemin; Lee, Regina; Chan, Sally Wai-Chi

doi:10.1136/bmjopen-2021-058425

Cited by 6 publications

(13 citation statements)

References 35 publications

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“…Compared to other malignancies, such as breast cancer where women are also faced with multiple treatment choices, prevalence of treatment decision regret was higher and varied between 11% and 43%. However, these studies mostly investigated younger women [28][29][30]. In a study focusing on older women with a median age of 72 years and a follow-up of 6 years after diagnosis, 24% of patients with breast cancer reported experiencing treatment decision regret [29].…”

Section: Variablementioning

confidence: 99%

Treatment decision regret in long‐term survivors after radical prostatectomy: a longitudinal study

et al. 2023

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To investigate prevalence, course, and predictors of longitudinal decision regret in long-term prostate cancer (PCa) survivors treated by radical prostatectomy (RP). Patients and MethodsA total of 1003 PCa survivors from the multicentre German Familial PCa Database completed questionnaires on average 7 years after RP in 2007 and at follow-up 13 years later in 2020. Patients completed standardised patient-reported outcome measures on decision regret, decision-making, health-related quality of life, and psychosocial factors. Hierarchical multivariable logistic regression was used to assess predictors of longitudinal decision regret. ResultsDecision regret increased significantly over time (9.0% after 6.9 years in 2007 and 12% after 19 years in 2020; P = 0.009). Favourable localised PCa (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.05-3.68), decision regret in 2007 (OR 6.38,, and a higher depression score (OR 1.37, 95% CI 1.03-1.83) were associated with decision regret in 2020. Shared decision-making (OR 0.55, 95% CI 0.33-0.93) was associated with less decision regret. ConclusionThe findings of the present study underline the perseverance of decision regret in long-term PCa survivors and the definitive need for involving patients in the decision-making process to mitigate regret over the long term.

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Section: Variablementioning

confidence: 99%

Treatment decision regret in long‐term survivors after radical prostatectomy: a longitudinal study

et al. 2023

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“…It has high reliability (Cronbach α, 0.81-0.92) and is well correlated with decision satisfaction, decisional conflict, and overall rated quality of life . The instrument has been used extensively for oncologic screening and treatment decisions as well as in nonclinical contexts …”

Section: Methodsmentioning

confidence: 99%

Long-Term Regret and Satisfaction With Decision Following Gender-Affirming Mastectomy

Bruce,

Khouri,

Bolze

et al. 2023

JAMA Surg

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ImportanceThere has been increasing legislative interest in regulating gender-affirming surgery, in part due to the concern about decisional regret. The regret rate following gender-affirming surgery is thought to be approximately 1%; however, previous studies relied heavily on ad hoc instruments.ObjectiveTo evaluate long-term decisional regret and satisfaction with decision using validated instruments following gender-affirming mastectomy.Design, Setting, and ParticipantsFor this cross-sectional study, a survey of patient-reported outcomes was sent between February 1 and July 31, 2022, to patients who had undergone gender-affirming mastectomy at a US tertiary referral center between January 1, 1990, and February 29, 2020.ExposureDecisional regret and satisfaction with decision to undergo gender-affirming mastectomy.Main Outcomes and MeasuresLong-term patient-reported outcomes, including the Holmes-Rovner Satisfaction With Decision scale, the Decision Regret Scale, and demographic characteristics, were collected. Additional information was collected via medical record review. Descriptive statistics and univariable analysis using Fisher exact and Wilcoxon rank sum tests were performed to compare responders and nonresponders.ResultsA total of 235 patients were deemed eligible for the study, and 139 responded (59.1% response rate). Median age at the time of surgery was 27.1 (IQR, 23.0-33.4) years for responders and 26.4 (IQR, 23.1-32.7) years for nonresponders. Nonresponders (n = 96) had a longer postoperative follow-up period than responders (median follow-up, 4.6 [IQR, 3.1-8.6] vs 3.6 [IQR, 2.7-5.3] years, respectively; P = .002). Nonresponders vs responders also had lower rates of depression (42 [44%] vs 94 [68%]; P &lt; .001) and anxiety (42 [44%] vs 97 [70%]; P &lt; .001). No responders or nonresponders requested or underwent a reversal procedure. The median Satisfaction With Decision Scale score was 5.0 (IQR, 5.0-5.0) on a 5-point scale, with higher scores noting higher satisfaction. The median Decision Regret Scale score was 0.0 (IQR, 0.0-0.0) on a 100-point scale, with lower scores noting lower levels of regret. A univariable regression analysis could not be performed to identify characteristics associated with low satisfaction with decision or high decisional regret due to the lack of variation in these responses.Conclusions and RelevanceIn this cross-sectional survey study, the results of validated survey instruments indicated low rates of decisional regret and high levels of satisfaction with decision following gender-affirming mastectomy. The lack of dissatisfaction and regret impeded the ability to perform a more complex statistical analysis, highlighting the need for condition-specific instruments to assess decisional regret and satisfaction with decision following gender-affirming surgery.

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“…The instruments were developed in Australia (Creyer and Ross, 1999), Canada (Brehaut et al, 2003;Godin et al, 2005), Italy (Marcatto and Ferrante, 2008), the United Kingdom (Sheeran and Orbell, 1999) and the United States (Tsiros, 1998;Schwartz et al, 2002;Keaveney et al, 2007). Among these instruments, Brehaut et al (2003) DRS has some interesting and robust psychometric features (such as being a brief single-factor model with high internal consistency and stability over time) reaffirmed in the studies that have employed it, both in its original form and in the form validated for other national contexts (Bonaccio and Girard, 2015;Becerra Pérez et al, 2016;Tanno et al, 2016;Advani et al, 2019;Calderon et al, 2019;Haun et al, 2019;Wilding et al, 2020;Xu et al, 2020;Telatar et al, 2021;Liu et al, 2022). So far, the use of the tool has been aimed at assessing regret in patients who have already made a medical decision.…”

Section: Introductionmentioning

confidence: 98%

The use of the Decision Regret Scale in non-clinical contexts

et al. 2022

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The Decision Regret Scale (DRS) was assessed for its psychometric qualities in measuring decision regret in ordinary life scenarios. Although the scale has typically been used with patients and in the context of medical decision-making in earlier studies, this contribution shows that the instrument may have a variety of uses, retaining excellent metric properties even in non-medical contexts. The tool showed good fits with both the CFA and the gender Measurement Invariance. A non-probabilistic selection of 2,534 Italian university students was conducted. The internal consistency measures were found to be completely appropriate. Correlations with the General Decision-Making Style (GDMS) and Scale of Regulatory Modes were used to check for convergent validity (SRM). Convergence analysis showed that participants with higher regret scores were those who favored a rational decision-making style, while lower regret scores correlated with avoidant and spontaneous styles. With regard to the regulatory modes, the relationship between regret and locomotion was positive. Overall, the directions of association point to an interesting predictive measure of a person’s decision-making and self-regulatory orientation through the evaluation of regret using the DRS. The excellent psychometric properties found foreshadow a reliable use in various contexts where knowledge of post-decisional attitude becomes important: school, university, professional orientation, marketing studies, relationship choices, as well as for use in research.

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Decision regret regarding treatments among women with early-stage breast cancer: a systematic review protocol

Cited by 6 publications

References 35 publications

Treatment decision regret in long‐term survivors after radical prostatectomy: a longitudinal study

Treatment decision regret in long‐term survivors after radical prostatectomy: a longitudinal study

Long-Term Regret and Satisfaction With Decision Following Gender-Affirming Mastectomy

The use of the Decision Regret Scale in non-clinical contexts

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