Treatment Decisions in Recurrent Head and Neck Cancer: A Cross-Sectional Study

Background: Decision-making in recurrent or metastatic head and neck cancer (HNC) is challenging, often involving high uncertainty and psychological distress. Objective: To identify factors contributing to decisional conflict in patients with recurrent or metastatic HNC. Methods: This cross-sectional study used convenience sampling to recruit participants from the outpatient department of a cancer center in northern Taiwan between August 2021 and July 2024. The Decisional Conflict Scale (DCS) and the University of Washington Quality of Life Scale (UW-QOL) were used to assess decisional conflict, physical function, and social-emotional function. Results: A total of 140 patients were recruited. Among them, 78.6% experienced decisional conflict. The main areas of concern were lack of support, ineffective decision-making, unclear values, insufficient information, and uncertainty. Patients with lower education, living alone, with lower family income, with private insurance, or with lower physical and social-emotional functioning were more likely to experience decisional conflict. Conclusions: Lower education, living alone, lower family income, private insurance, or lower physical or social-emotional function contribute significantly to decisional conflict in patients with recurrent or metastatic HNC. Healthcare providers should incorporate targeted interventions addressing these factors into the shared decision-making processes to reduce decisional conflict and enhance patient-centered care.