15250-m-cuypers

136 Chapter 7 Measures Age, marital status, and education level were obtained from the questionnaire. The treatment that was received by the patients was verified through their medical record. Regret after the treatment decisionwas assessedwith the five-itemDecisionRegret Scale (DRS) (16). All questions were answered on a 5-point scale, ranging from 1-completely disagree to 5-completely agree. Scores were transformed to a 0-100 scale. Previous studies used a cutoff score of >25 as indicative for moderate to strong regret (18, 36, 37). Regret was assessed at T2 and T3. Internal consistency was good (Cronbach’s alphas 0.84-0.87). Patient satisfaction consisted of treatment satisfaction and information satisfaction. Treatment satisfaction was assessed with a single item (‘Are you satisfied with how your treatment is or was executed’), to get an overall estimation of satisfaction. Since participants in our trial were exposed to different treatments, questions about specific aspects of treatment would not apply to all participants. Moreover, the single- item question contributed to limit the questionnaire length and patient burden when completing it. The questionwas answered on a 5-point scale, ranging from1-completely disagree to 5-completely agree, and transformed to a 0-100 scale. Treatment satisfaction was assessed at T2 and T3. Information satisfaction was assessed with the Satisfaction with Cancer Information Profile part B (SCIP-B) (38). Answers were given on a 5 point scale, ranging from 1-very dissatisfied to 5-very satisfied, and transformed to a 0-100 score. Information satisfaction was assessed at all three time points. Internal consistency was good (Cronbach’s alphas 0.95-0.97). An earlier study into retrospective information satisfaction in Pca survivors showed that decision role preferences were associated to information satisfaction even at four years after decision-making (39). Therefore, the perceived patient role during treatment counseling, assessed at T1 with the Problem-Solving Decision-Making (PSDM) Scale, was included into our analysis as covariate (40). The PSDM scale represents the level of involvement in weighing treatment pros and cons and in making the decision, ranging from 1-passive (doctor only) to 5-active (patient only) involvement. The first two and last two answer categories were each combined, resulting in a doctor-driven, shared or patient-driven role. Furthermore, anxious and depressive symptoms were included as covariate, which are a common factor in Pca treatment decision-making, and showed an association to the DA evaluation immediately following decision- making (41, 42). Presence of anxious or depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) (43). Both aspects were measured with a seven-item subscale. The answering scale ranged from 0-3, and answers were summed to obtain anxious and depressive scores. Scores ≥8 are generally seen as substantial levels of anxiety or depression (43). HADS was assessed at all three time points. Internal

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