Decision regret and shared decision-making in patients undergoing hyperbaric oxygen therapy

Hyperbaric oxygen therapy (HBOT) is used for various medical conditions. HBOT is demanding and varies in effectiveness. This intensity combined with logistical challenges may lead to patients regretting undergoing HBOT. Therefore, shared decision-making (SDM) seems applicable when considering HBOT. The goal of this study was to assess the level of SDM as perceived by HBOT patients and relate this to post-hoc regret about choosing HBOT.

Patients referred for ≥ 10 sessions HBOT, were recruited for this prospective cohort study. Participants completed the SDM-Q-9 and SDM-K-Q questionnaires within one week of HBOT initiation. At least six weeks after HBOT completion or discontinuation participants completed the Decision Regret Scale (DRS) questionnaire. Multivariable linear regression analysis was applied to find factors influencing decision regret and SDM.

Sixty-two patients (mean age 61.5 years; 36 female), primarily treated for radiation-related injuries, were included. Minor complications, including fatigue and temporary visual changes, were common. Mean SDM-Q-9 and SDM-K-Q scores were 61.9% and 72.1%, respectively. Among 54 patients completing the DRS, mean regret score was 13.4%. Lower regret correlated with symptom improvement (B = -16.56, P = 0.036) and more side effects (B = -6.81, P = 0.014). Males tended to report more regret (B = 8.26, P = 0.081), while age and SDM-Q-9 scores were not significant predictors. No factors significantly affected SDM-Q-9 scores.

HBOT patients reported limited involvement in decision-making and low levels of regret. Interestingly, minor complications were associated with less regret, suggesting complex dynamics in patient experience and treatment justification. These findings highlight the importance of individualised shared decision-making and patient education in the context of HBOT to ensure treatment choice aligns with patient values and expectations.