Self-efficacy, psychological adjustment and decisional-balance regarding decision making for outpatient chemotherapy in Japanese advanced lung cancer

Abstract

This study examined the application of the trans-theoretical model (TTM) for readiness for decision-making of outpatient chemotherapy of Japanese advanced lung cancer patients by a cross sectional questionnaire survey. A questionnaire was conducted with 105 Japanese patients diagnosed with advanced lung cancer receiving chemotherapy. We classified them according to the TTM stages, including 4 in precontemplation, 42 in contemplation, 22 in preparation, and 35 in action. The valid model (χ ² (37) = 42.56, p = 0.24; GFI = 0.93; AGFI = 0.88; CFI = 0.98; RMSEA = 0.04; AIC = 100.56) derived from structural equation modeling (SEM) revealed that stage of outpatient chemotherapy was significantly affected mostly by decisional-balance (β = 0.60, p < 0.001) and partially by time from the patient's house to the hospital (β = −0.15, p < 0.10), and that decisional-balance was significantly affected by self-efficacy (β = 0.48, p < 0.001) and nausea (β = −0.23, p < 0.01). The findings from our study provided encouraging results for adopting the TTM in decision making for outpatient chemotherapy in Japanese cancer care and several clinical implications were obtained from the results.

Keywords:

• trans-theoretical model
• decisional-balance
• self-efficacy
• outpatient chemotherapy
• lung cancer

Acknowledgments

This work was supported by a Grant-in-Aid for Cancer, from the Japanese Ministry of Health, Labor and Welfare and by a Grant-in-Aid for Scientific Research (No. 16730350) from Japan Society for the Promotion of Science. We thank to Masaaki Kawahara, Mitsumasa Ogawara, Koichiro Oka, Nanako Nakamura, Tatsuya Morita, Mariko Shiozaki, Kayo Ikeda for helpful comments on this article.