110 | Chapter 4 Table 1. Continued Patients (N=45) N (%) Educational level**: Lower educational level Intermediate educational level Higher educational level 24 (53) 18 (40) 3 (7) Employed: Yes No Sickness benefits law / Sickness insurance law Retired 8 (18) 16 (36) 2 (4) 19 (42) Family member dependent on income Yes No 16 (36) 29 (64) Counseling physician*** Medical oncologist Radiation oncologist Head-and-Neck surgeon 1 (3) 6 (17) 28 (80) Abbreviations: SD= Standard Deviation; N = sample size; TN = Tumor, Node; RT = radiotherapy; CRT = chemoradiation, cis = cisplatin; cet = cetuximab; TL = total laryngectomy. *TN-classification; TN-classification was documented instead of TNM-classification (UICC version 8) since the presence of distant metastasis (M) was an exclusion criterion. ** Lower: Primary general and primary vocational education. Intermediate: Secondary vocational and general secondary education. Higher: Higher vocational and academic education *** Since not all physicians returned their questionnaires, the numbers add up to 35 (100%). We do not have access to the characteristics of the other physicians. Decisional Conflict The median DCS after counseling was 73.44 (range 25-100). Almost all patients experienced CSDC (44/45, 97.8%). The median DCS six months after treatment was 73.44 (range 0-100), and 22/26 patients (84.6%) still experienced CSDC. A moderate positive correlation was observed between the baseline DC scores and the scores after treatment (Spearman r=0.589, p=0.002). As shown in figure 2, the patient with no CSDC at T1 maintained the same score at T2 (DCS=25). Three other patients did have CSDC at T1 (scores ranging 34.38-75.00) but did not at T2. All five subscales (Uncertainty, Informed, Values Clarity, Support, and Effective Decision) had a median score of 75.00 at T1, with only the Uncertainty subscale decreasing to a median score of 66.67 at T2. There was no significant change in the DCS score (MannWhitney-U test, p= 0.405) and subscales over time (table 2).
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