Needs Assessment for a Decision Aid in Oral Cancer Requiring Major Resection and Reconstructions.

Area of Science:

• Oncology
• Health Services Research
• Patient Decision Making

Background:

• Advanced oral cavity cancer treatment involves life-altering surgery, balancing survival with quality of life.
• Shared decision-making (SDM) is crucial but current practices require examination.
• The need for effective decision support tools in this patient population is significant.

Purpose of the Study:

• To describe current shared decision-making practices for advanced oral cavity cancer patients.
• To identify patient-centered needs for improved decision support tools.

Main Methods:

• A convergent mixed-methods study was conducted from 2020-2023 at two Canadian academic centers.
• Semi-structured interviews with 37 patients were analyzed thematically.
• Qualitative data were integrated with validated instruments measuring SDM, decisional conflict, and self-efficacy.

Main Results:

• Key themes influencing decisions included information delivery, preoperative experiences, knowledge gaps, and fear of cancer.
• 18.9% of patients experienced significant decisional conflict despite high self-efficacy.
• Higher SDM perception and decisional self-efficacy correlated with lower decisional conflict.

Conclusions:

• Findings underscore the necessity for enhanced, integrated decision support tools.
• Improved tools should be accessible, provide treatment timelines, and facilitate clinician-patient communication.
• These tools can empower patients and optimize shared decision-making in advanced oral cavity cancer care.