116 | Chapter 4 Surprisingly low scores were found on the treatment knowledge tests. Patients answered less than half of the questions correctly. RT questions were answered most accurately, followed by CRT, and the lowest scores for TL. These results highlight the need for better education, counseling, and interventions to enhance patients’ understanding, particularly regarding TL. Improving patients’ knowledge could facilitate a more informed decision-making process, which is key for shared decision-making. Patient Decision Aids (PDA) are effective tools to improve patient knowledge and reduce DC46,47. Awareness of these high levels of CSDC might motivate physicians to pay extra attention to their counseling, especially in increasing patients’ involvement and focusing on their preferences and values in life. Though it is hard to implement all these factors during counseling, proper training and using PDAs can contribute to higher knowledge levels, more engagement and hopefully a reduction in DC. The results of the impact of our PDA for locally advanced laryngeal cancer patients will follow in near future21. Limitations Since this data is part of a more extensive study, this study was not powered for specific hypothesized correlations. Secondly, SDM questionnaires are subjective and have shown to overestimate the objectively performed SDM42,43. So these SDM data should be interpreted cautiously, and a more objective measure would be helpful to obtain a more reliable SDM outcome. Thirdly, only 26 patients (57.8%) handed in the questionnaires six months after treatment (T2), making it hard to draw conclusions on changes over time.
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