The relationships among knowledge, self-efficacy, preparedness, decisional conflict, and decisions to participate in a cancer clinical trial
Article first published online: 14 FEB 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Volume 22, Issue 3, pages 481–489, March 2013
How to Cite
Miller, S. M., Hudson, S. V., Egleston, B. L., Manne, S., Buzaglo, J. S., Devarajan, K., Fleisher, L., Millard, J., Solarino, N., Trinastic, J. and Meropol, N. J. (2013), The relationships among knowledge, self-efficacy, preparedness, decisional conflict, and decisions to participate in a cancer clinical trial. Psycho-Oncology, 22: 481–489. doi: 10.1002/pon.3043
- Issue published online: 1 MAR 2013
- Article first published online: 14 FEB 2012
- Manuscript Accepted: 14 JAN 2012
- Manuscript Revised: 4 JAN 2012
- Manuscript Received: 19 AUG 2011
- National Cancer Institute. Grant Numbers: R01 CA127655, K01 CA131500, P30CA06927
- clinical trials;
Cancer clinical trials (CCTs) are important tools in the development of improved cancer therapies; yet, participation is low. Key psychosocial barriers exist that appear to impact a patient's decision to participate. Little is known about the relationship among knowledge, self-efficacy, preparation, decisional conflict, and patient decisions to take part in CCTs.
The purpose of this study was to determine if preparation for consideration of a CCT as a treatment option mediates the relationship between knowledge, self-efficacy, and decisional conflict. We also explored whether lower levels of decisional conflict are associated with greater likelihood of CCT enrollment.
In a pre–post test intervention study, cancer patients (N = 105) were recruited before their initial consultation with a medical oncologist. A brief educational intervention was provided for all patients. Patient self-report survey responses assessed knowledge, self-efficacy, preparation for clinical trial participation, decisional conflict, and clinical trial participation.
Preparation was found to mediate the relationship between self-efficacy and decisional conflict (p = 0.003 for a test of the indirect mediational pathway for the decisional conflict total score). Preparation had a more limited role in mediating the effect of knowledge on decisional conflict. Further, preliminary evidence indicated that reduced decisional conflict was associated with increased clinical trial enrollment (p = 0.049).
When patients feel greater CCT self-efficacy and have more knowledge, they feel more prepared to make a CCT decision. Reduced decisional conflict, in turn, is associated with the decision to enroll in a clinical trial. Our results suggest that preparation for decision-making should be a target of future interventions to improve participation in CCTs. Copyright © 2012 John Wiley & Sons, Ltd.