Abstract
Objectives
Patients diagnosed with acute myeloid leukemia (AML) can often feel overwhelmed at
having to make a difficult and time-sensitive treatment decision in this life-threatening
illnes. We sought to explore information needs, control preferences, decisional regret,
and decisional satisfaction in adult patients with AML and to explore differences
by age group.
Methods
We recruited 35 consecutive English-speaking patients with recently diagnosed AML,
evenly split between older ( age 60+, n=17) and younger (n=18) adults. We administered questionnaires including the satisfaction with decision
making scale, decisional regret scale, control preferences scale, and quality of life
questions at one or two key time points: start of chemotherapy, end of induction chemotherapy,
and end of intensive chemotherapy.
Results
52% of patients preferred a passive decision-making role. Most patients (80%) achieved
their preferred decision-making role. Overall decisional satisfaction scores were
high and regret scores were low, but there was a trend toward less satisfaction with
more passive decision-making roles (p=0.066). Most patients had a high level of trust in their physician. Physicians and
nurses were reported as the most useful sources of information. There were no significant
differences in any of these outcomes by age group. Quality of life and fatigue were
also similar among older and younger patients.
Discussion
These findings demonstrate similarities in information and decisional issues in older
and younger adults with AML and highlight the need for further study of decisional
regret and satisfaction over time in this patient population.
Keywords
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Biography
Hassanabbas Mohamedali is a second-year Undergraduate Pharmacy student at the University of Toronto. He is interested in clinical research involving drug toxicity in patients with and without cancer.
Biography
Ms. Henriette Breunis is a Research Coordinator working with Dr. Shabbir Alibhai on several research studies in prostate cancer and acute myeloid leukaemia. In addition, she works occasionally as a monitor for the National Cancer Institute of Canada Clinical Trials Group’s Audit and Monitoring Committee. Henriette holds a degree in library science and is a certified clinical research professional.
Biography
Mr. Abbas Panju participated in this study while an undergraduate student in arts and science. He is currently pursuing a Master’s degree in Business Administration at McMaster University in Hamilton, Ontario, Canada and is interested in studying medicine.
Biography
Shabbir M.H. Alibhai, MD, MSc is an Assistant Professor in the Departments of Medicine and Health Policy, Management, and Evaluation at the University of Toronto. He is a staff physician and researcher at the University Health Network and Toronto Rehabilitation Institute, and a Research Scientist of the Canadian Cancer Society. His research interests are in geriatric oncology, particularly in understanding treatment-related toxicities, enhancing treatment decision making, and improving quality of life, fatigue, and function in older people with prostate cancer and acute leukemia.
Article info
Publication history
Published online: July 21, 2010
Accepted:
June 11,
2010
Received:
May 28,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
