Mariken Stegmann

Symptoms of fatigue, anxiety, and depression  Continuous scores. The mean fatigue scores were 62.9 (SD = 21.2) in the OPT group and 67.1  (SD = 18.6) in the control group (95% CI = –11.28 to 3.8; P = 0.33). The mean anxiety score  was 6.0 (SD = 4.6) in the OPT group and 7.6 (SD = 4.4) in the control group, a statistically  significant difference of –1.67 (95%CI = –3.33 to –0.01; P<0.05). The mean depression score  was 5.9 (SD = 4.8) in the OPT group and 6.4 (SD = 4.1) in the control group (95%CI = –2.02 to  1.28; P = 0.66).  Dichotomised scores. The proportion of patients with mild fatigue was statistically  significantly lower in the OPT group than in the control group (58.8%, n = 30 versus 77.2%, n  = 44; P = 0.05), while this was not the case for the proportion of patients with severe fatigue  (33.3%, n = 17 versus 40.4%, n = 23; P = 0.32). Fewer patients in the OPT group had either  mild anxiety (30.6%, n = 15 versus 40.7%, n = 24; P = 0.28) or severe anxiety (12.2%, n = 6  versus 20.3%, n = 12; P = 0.55). In the OPT group, there were fewer patients with mild  depression (28.6%, n = 14 versus 37.3%, n = 22; P = 0.34) or severe depression (16.3%, n = 8  versus 18.6%, n = 11; P = 0.75) (see Table 2).  Table 2. Comparison of outcomes between intervention group and control group OPT  Control  OPT versus Control  N = 53  N = 61  Continuous outcomes Mean   ±SD  Mean   ±SD  Difference  (95% CI)  Patient empowerment: DSE  a, b 86.8  18.2  84.2  17.6  2.54  (‐4.46 to 9.54) Fatigue: MFI  a 62.9  ±21.2  67.1  ±18.6  ‐3.72 (‐11.28 to 3.83)  Anxiety: HADS‐A  a 6.0  ±4.6  7.6  ±4.4  ‐1.67 (‐3.33 to ‐0.01)*  Depression: HADS‐D  a 5.9  ±4.8  6.4  ±4.1  ‐0.37 (‐2.02 to 1.28)  Dichotomous outcomes N  (%)  N  (%)  OR  (95% CI)  Patient empowerment  a  DSE < 75 9 (18.8)  14 (24.1)  0.73 (0.28–1.86)  Fatigue  a MFI ≥ 58 30 (58.8)  44 (77.2)  0.44 (0.19–1.00)  MFI ≥ 73 17 (33.3)  23 (40.4)  0.67 (0.30–1.47)  Anxiety  a  HADS‐A ≥ 8  15  (30.6)  24  (40.7)  0.64  (0.29–1.43)  HADS‐A ≥ 11  6  (12.2)  12  (20.3)  0.55  (0.19–1.58)  Depression  a HADS‐D ≥ 8  14  (28.6)  22  (37.3)  0.67  (0.30–1.52)  HADS‐D ≥ 11 8  (16.3)  11  (18.6)  0.85  (0.31–2.32)  Abbreviations: DSE, decision self‐efficacy; HADS‐A, Hospital Anxiety and Depression Scale (anxiety subscale);  HADS‐D, Hospital Anxiety and Depression Scale (depression subscale); IQR, interquartile range; MFI,  multidimensional fatigue inventory; OPT, Outcome Prioritisation Tool; SD, standard deviation.  * p < 0.05  a  Due to incomplete questionnaires, the numbers of analysed cases in the OPT group were 48 for  DSE, 51 for MFI, 49 for HADS‐ A, and 49 for HADS‐D; the corresponding numbers in the control group were 58,  57, 59, and 59, respectively.  b Adjusted means and estimated β (95% confidence interval) for the intervention  compared to the control group by Tobit regression analysis. 46 Chapter 4