Personal Values Are Associated with the Impact of Cancer Treatment Side-Effects on Goal Achievement

Peter Veazie, PhD; Julia Weaver; Viji Kannan, MSPH

Introduction

Information Representation Goal Decision• Benefits• Side-effects

• Concrete• Details

• Concrete• Near-term

• Minimize side-effects (subject to clinical benefits)

Core Values

Representation Goal Decision

• Long-term related values • Abstract

• General characteristics

• Values driven• Future

focused

• Maximize ability to achieve long-term goals

Information• Benefits• Side-effects

Long-term expectations

Decision outcomes

Regret

RegretDecision outcomes

Bottom-up processing of novel information

Top-down processing of novel information

• Patients can experience regret after treatment decisions• Degree of regret is related to the extent of mismatch between decision

outcomes , long terms expectations, and potential outcomes of alternatives• Decisions are based on situation and goals representations • In novel situations, these can be detailed bottom-up or abstract top-down

representations:

Research Question

Are personal values associated with the judgment that side-effects will impact life-time goal achievement?

Would pre-decisional priming of core personal values modify evaluation of side-effects to decrease long-term regret?

?

If so, then the judgment that a side-effect impacts life goals should be related to core values.

Methods

SAMPLE: The data were collected from a survey of 271 healthy persons registered with ResarchMatch, a database of 78,000 volunteers across the US willing to consider participation in research studies.

SURVEY QUESTIONS: In addition to demographics, participants were asked whether each of 18 cancer treatment side-effects would affect their ability to achieve their goals; judgments were made on a 7-point scale spanning “No effect on achieving goals” to “Severely decrease ability to achieve goals”. Participants were also asked to complete the 56-item Schwartz Values Scale from which 10 value types and 4 general value categories.

SIDE-EFFECTS

Physical symptoms

pain nausea fatigue

shortness of breathtingling in hands/feet

numbness in hands/feet swelling

Stigma

incontinencedecreased fertility

scarring hair loss blisters

mouth sores

Emotion anxiety depression

Mental dizziness

headachesmemory problems

SCHWARTZ 10 VALUE TYPES AND 4 CATEGORIESIn the circular structure, adjacent values have more similar behavioral implications, whereas values that are across from each other have opposing behavioral implications.

DEMOGRAPHICS: The sample included 80% females, mean age of 42 spanning 19 to 83 (SD = 15), 88% non-Hispanic white and 6% Black, and 14% without a college degree.

Results

ANALYSIS: An Ordered Logistic Regression of each side-effect on each value (adjusting for age and sex) was used to determine associations. A significance level of 0.1 is used as the evidence threshold. P-values are adjusted for multiple comparisons within each value (i.e. across the 18 side-effects for each value);.

4

6

3

12

5

4

11

1

UniversalismBenevolenceGroup SecurityTraditionConformityIndividual SecurityPowerAchievementHedonismStimulationSelf Direction

Self-transcendent; 13

Conservation; 3

Self-enhancement; 9

Open to change; 3

Number of significant side-effects for value category

Self-transcendent Conservation Self-enhancement Open to change

Physical Stigma Emotional Mental0

1

2

3

4

5

6

7

6

0

5

22

5

1 1

Side-effect type

Self-transendent Self-enhancement

Results DiscussionNumber of significant side-effects for each value type Summary:

• Each value, except Achievement, is associated with at least one side-effect• Six of the ten values are associated

with 2 or more side-effectsConclusion:• Values are associated with the

judgment that side-effects decrease the ability to achieve goals

Summary:• Each value category is associated with

at least 3 side-effects• Self-enhancement values and Self-

Transcendent values are related to the most side-effects

Conclusion:• Most of the evidence for associations

with side-effects impacting goals is related to opposing groups of values (i.e. behaviors that achieve one tend to discourage the other)

Summary:• Self-transcendent values are related to

more Physical and Emotional side-effects• Self-enhancement values are related to

more Stigma side-effectsConclusion:Different categories of core values are concerned with different types of side-effects