Decisional conflict scale for elective thoracic surgery

Background: Decisional conflict is expected to occur in the surgical field though the research targeted decision at surgery has been rarely performed. We prospectively researched decisional conflict using a questionnaire survey for patients with elective thoracic surgery and retrospectively reviewed and analyzed the quantified and subcategorized data to examine clinical factors related with the decisional conflict scale (DCS) and the quality of life (QOL) score. Methods: For patients with thoracic surgery, self-administered questionnaire surveys regarding decisional conflict and QOL were conducted at three time points: the day before surgery, at discharge, and at 3 months after surgery. The questionnaire survey of DCS is composed of five categories that use a five-point Likert-type response. QOL was measured in the Japanese version of the M.D. Anderson Symptom Inventory. Results: The DCS and QOL questionnaire surveys were performed from April 2017 to March 2023. Data from 496 patients were analyzed in this study. The total DCS scores differed among pre-surgery, post-surgery, and 3 months after surgery (20.0, 17.1, and 16.9, respectively; P<0.001). The subscores of values clarity, support, and effective decision significantly decreased after surgery (P values: 0.01, 0.005, and <0.001, respectively). The DCS scores in patients with open thoracotomy were higher than those in patients with video-assisted thoracoscopic surgery (VATS) (P=0.01 at pre-surgery). At 3 months after surgery, all QOL scores were significantly correlated with the total scores of DCS. Conclusions: Patient's experience of thoracic surgery and post-operative management may decrease patient dissatisfaction. The findings suggest that decisional support for patients to organize their concrete perioperative management would ameliorate their satisfaction.