Patient perspective on pre-operative communication; a post-operative cross-sectional survey of patients with gastro-intestinal malignancy

TL;DR

This study explores how well patients with gastrointestinal cancer felt informed and confident about their decision to undergo surgery, finding generally positive perceptions but noting that some patients with poor outcomes may need more support.

Contribution

The study provides new insights into patient-reported outcomes related to decision-making effectiveness and regret following major cancer surgery.

Findings

Most patients reported high confidence in their decision to undergo surgery.

Higher education levels were linked to lower decision regret.

Longer hospital stays were associated with increased decision regret.

Abstract

Undergoing major cancer surgery is an important decision for patients. This study assessed the effectiveness of decision-making following colorectal and oesophageal cancer surgery.

Patients who had undergone colorectal and oesophageal cancer surgery in two UK centres over two years were identified. Validated patient reported outcomes (PROs) were collected by cross sectional survey including perceived confidence in decision-making and effectiveness of risk communication (COMRADE scale), decision regret (Decisional Conflict Score; DCS), and quality of life (EORTC QLQ-PAL15). Uni-variable linear regression was used to explore the relationship between PRO scores and clinical and sociodemographic variables.

Some 143/244 (58%) patients returned the questionnaire. Overall, decision regret was low (median 7.81, range 0–23.4), and perceived confidence in decision-making and effectiveness of risk communication was good (median 95 (75–100) and 85 (70–100) respectively). Higher education level was associated with reduced regret (−0.7; CI −1.2 to −0.1;p = 0.016) and a longer length of hospital stay was associated with higher regret (1;CI 0.2–1.9;p = 0.014).

Patients perceived decision-making to be effective in this study, but those with adverse outcomes may benefit from further support.