Decisional Conflict in Palliative Head and Neck Cancer Patients

Area of Science:

• Oncology
• Palliative Care
• Health Psychology

Background:

• Decisional conflict (DC) is a significant concern for patients with head and neck cancer (HNC).
• Limited research exists on DC within the palliative phase of HNC.
• Understanding DC is vital for enhancing patient-centered care.

Purpose of the Study:

• To assess and describe DC in palliative HNC patients.
• To explore the association between clinically significant DC and quality of life (QoL).
• To differentiate DC levels between incurable HNC and those refraining from curative treatment.

Main Methods:

• Prospective cohort study conducted at a tertiary cancer center.
• 104 HNC patients in the palliative phase were assessed (September 2022 - March 2024).
• Decisional Conflict Scale (DCS) and EORTC QLQ-C15-PAL for QoL were utilized.

Main Results:

• Clinically significant DC (≥25) was found in 65.3% of incurable HNC patients and 43.8% of those refraining from curative treatment.
• Tumor stage I/II predicted less DC in patients refraining from curative treatment.
• Significant QoL differences were noted based on DC levels in both cohorts.

Conclusions:

• Clinically significant DC is more prevalent in palliative patients with incurable HNC compared to those choosing not to pursue curative treatment.
• Distinct patterns of DC and QoL exist between these patient groups.
• Tailored counseling is essential for supporting patient-centered care in palliative HNC.