Self-efficacy of advanced cancer patients for participation in treatment related decision- making: the ACTION study.

Abstract Purpose: Many patients prefer an active role in making decisions about their care and treatment, but participating in such decision-making is challenging. The aim of this study was to investigate whether patient reported outcomes (quality of life and patient satisfaction), patients’ coping strategies, sociodemographic and clinical characteristics were associated with self-efficacy for participation in decision-making among patients with advanced cancer. Methods: We used baseline data from the ACTION trial of patients with advanced colorectal or lung cancer from six European countries, including scores on the Decision-making Participation Self-efficacy (DEPS) scale, EORTC QLQ-C15-PAL questionnaire and the EORTC IN-PATSAT32 questionnaire. Multivariable linear regression analyses were used to examine associations with self-efficacy scores. Results: The sample included 660 patients, mean age 66 years (SD 10). Patients had a mean score of 73 (SD 24) for self-efficacy. Problem-focused coping (B 1.58 (95% CI 0.91 to 2.25)), better quality of life (B 3.60 (95% CI 2.22 to 4.98)) and more patient satisfaction (B 8.02 (95% CI 6.02 to 10.10)) were associated with a higher level of self-efficacy. Patients in the Netherlands had a higher level of self-efficacy than patients in Belgium ((B 10.77 (95% CI 5.47 to 16.07)), whereas Italian patients had a lower level ((B -7.38 (95% CI -12.94 to -1.83)) than those in Belgium. Conclusion: Coping style, quality of life and patient satisfaction with care were associated with self-efficacy for participation in decision-making among patients with advanced cancer. These factors are important to consider for healthcare professionals when supporting patients in decision-making processes.