Ietje Perfors

114 Chapter 5 scale and focuses on the decision process in hospital. 21 A score was calculated, which ranged from 0-100. A higher score indicated higher perceived SDM. During the trial, we added a statement to specify the role of the GP in this process “My GP helped me make my choice of treatment”, which was analysed separately. Secondary outcomes Received information was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Group information questionnaire (EORTC-info 26), a 27-item cancer specific questionnaire with a four-point Likert scale. 22 This questionnaire assessed the amount of information received on multiple cancer-related themes (diagnosis, medical tests, treatments, other services, places of care and self-help) and the satisfaction and usefulness of received information. With the items a score was calculated, which ranged from 0-100. A higher score indicates a better perceived information provision. Self-efficacy is defined as “the individual’s capacity to produce desired effects”. 23 Perceived self-efficacy was measured using the Perceived self- Efficacy in Patient-Physician Interactions (PEPPI-5) questionnaire, which contains 10 items with a five-point Likert scale. 24 With these items a score was calculated which ranged from 5-25. A higher score indicates higher perceived self-efficacy. Intervention adherence Adherence to the protocol for the content and planning of the TOC was assessed using the free text in the Electronic Medical Record (EMR) data of GP contacts in the intervention group. EMR data are registered for each GP consultation as part of usual care. Performance of the content of the TOC according to protocol was confirmed if the free text noted referred to components of the TOC intervention. Timing of the TOC according to protocol was defined as a TOC between diagnosis and treatment decision. Dates from the primary care and hospital EMR were used. Consultations in the control