Decisional conflict in patients scheduled for insertion of a Central Venous Catheter to receive chemotherapy: protocol for a cross-sectional study
Journal Title: Biomedicine & Prevention - Year 2018, Vol 2018, Issue 1
Abstract
Introduction Decisional conflict is defined as "the subjective uncertainty about the best choice to make when the options are competing with each other and involve risk, loss, regret or challenge to personal values". Although uncertainty is an intrinsic characteristic of the choice of the patient between several possible options, certain factors can intensify it, as the lack of knowledge, unrealistic expectations, unclear values, pressures from others, social context and lack of support in the decision-choice. An example of a choice requiring involvement of the patient scheduled to receive chemotherapy is the proposal of the insertion of a Central Venous Catheter (CVC). Despite the CVCs ensure greater freedom of movement and are safer for the administration of chemotherapy, patients report negative perceptions, inadequate knowledge and are often concerned about their device. In addition, the perception of self-efficacy of patients in informed choices play a central role in the decision-making process. The main purposes of the study are to verify the occurrence of decisional conflict, to describe the factors influencing it, to assess the knowledge and self-efficacy in cancer patients to whom it was proposed the placement of a CVC for administration of intravenous chemotherapy. Secondary aims are to test the psychometric properties of the questionnaires used. Materials and Methods Single centre cross-sectional study. The Ottawa Decision Support Framework (ODSF) was applied as it provides a framework for developing interventions for decision support, it includes tools for analysis of the factors contributing to decisional conflict and provides tools aimed at improving the quality of decision making. Therefore three self-administered questionnaires adapted from ODSF will be used to assess 1) decisional conflict (Decisional Conflict Scale-DCS), 2) self-efficacy (Decision Self-Efficacy) and 3) knowledge of patients with indication to the positioning of a CVC to receive intravenous chemotherapy. The psychometric properties of the three questionnaires will be tested through exploratory or confirmatory factor analyses. The models will be assessed using several criteria among the following: Chi-square (χ2); Comparative Fit Index (CFI); Tuker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA) and the Standardized Root Mean Square Residual (SRMR). The quality of the factors will be analyzed through the factor score determinacy coefficients and reliability through Cronbach's Alpha Coefficient. Correlation between the scores of the Self-efficacy Scale and the DCS will be evaluated by Pearson’ correlation coefficient. Discussion: Results from the study will test the psychometric properties of three questionnaires based on the Ottawa Decision Support Framework. The provision of valid and reliable tools will enable to identify decisional conflicts, their causes, and the interventions that can help to solve them. This will allow developing patient education plans tailored to the needs of individuals in the decision-making process.
Authors and Affiliations
Maria Rosaria Esposito, Michela Piredda, Assunta Guillari, Maria Grazia De Marinis
Keywords
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- EP ID EP336297
- DOI 10.19252/00000007B
- Views 129
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