A Model of Consultation in Prostate Cancer Care

Abstract

Background: There has been an evolution of various consultation models in the literature. Men affected by prostate cancer can experience a range of unmet supportive care needs. Thus, effective consultations are paramount in the delivery of supportive care to optimize tailored self-management plans at the individual level of need. Objective: The aim of this study is to critically appraise existing models of consultation and make recommendations for a model of consultation within the scope of clinical practice for prostate cancer care. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement Guidelines. Electronic databases were searched using a wide range of keywords and free text items to increase the sensitivity and inclusiveness of the searches. Findings were integrated in a narrative synthesis. Results: A total of 1829 articles were retrieved and 17 papers were included. Beneficial features ranged across a number of models that included a person-centered consultation, shared management plans, and safety netting. None of the reviewed models of consultation are suitable for use in prostate cancer care because of a range of limitations and the clinical context in which models were developed. A Cancer Care Consultation Model was informed from critical appraisal of the evidence and expert clinical and service user comment. Conclusion: Further research is needed to empirically test consultation models in routine clinical practice, specifically for advanced cancer specialist nurses. Implications for Practice: The Prostate Cancer Model of Consultation can be used to structure clinical consultations to target self-management care plans at the individual level of need over the cancer care continuum.

A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers

“…The intervention was developed using the Medical Research Council Framework for complex interventions (Craig et al, 2008) and the six steps in quality intervention development (6SQuID) (Wight et al, 2015). The intervention was informed by the Prostate Cancer Model of Consultation (Paterson and Nabi, 2016) and comprised four main components: 1) informational materials, 2) holistic needs assessment, 3) individualised self-management care plans, and 4) group-based seminar. The intervention and associated materials were developed in consultation with multidisciplinary healthcare experts involved in prostate cancer and patient's representatives.…”

“…ThriverCare (Paterson et al, 2017;Primeau et al, 2017) was designed in the present study and tested through a pilot randomised controlled trial. Thrivercare was informed by the Prostate Cancer Model of Consultation as the underpinning theoretical study model (Paterson and Nabi, 2016). ThriverCare was developed to address unmet care need concerns, normalise follow-up treatment experience, and move beyond prostate cancer survivorship to cancer thrivership (Weiner et al, 2005).…”

Non‐medical prescribing in prostate cancer care: a case study reflection

“…Therefore, central to safe and effective prescribing practice, non-medical prescribers may need to formulate a differential diagnosis and develop robust evidence-based clinical management plans during clinical consultations. A recent systematic review critically appraised existing models of consultation to date (Paterson and Nabi, 2016), and concluded that none of the reviewed models in the available literature are suitable for use in prostate cancer for the following reasons: (i) no recognition of the cancer care continuum and its influence on consultations, (ii) lack of supported self-management recognizing cancer as a long-term condition, (iii) no appreciation of the complex factors that influence consultation for each individual man affected by prostate cancer (demographic, self-efficacy, cultural, etc.) As such, a consultation may be initiated by the healthcare professional to provide health promotional intervention, or by the patient when they are unwell (Denness, 2015).…”

“…This poses the question about the suitability of existing models in the clinical context of prostate cancer care. A recent systematic review critically appraised existing models of consultation to date (Paterson and Nabi, 2016), and concluded that none of the reviewed models in the available literature are suitable for use in prostate cancer for the following reasons: (i) no recognition of the cancer care continuum and its influence on consultations, (ii) lack of supported self-management recognizing cancer as a long-term condition, (iii) no appreciation of the complex factors that influence consultation for each individual man affected by prostate cancer (demographic, self-efficacy, cultural, etc.) and (iv) very little acknowledgement of the evidence base to inform management plans within the consultation itself.Therefore, a new model of consultation (Paterson and Nabi, 2016) was informed from appraisal of the empirical literature, and expert guidance from men affected by prostate cancer and members of the MDT, see Figure 1.…”

Nurses' consultative role to health promotion in patients with chronic diseases

“…[121718] The results of nursing consultation include improving quality of life, satisfaction, awareness, and adherence in patients; preventing and reducing distress, stress, anxiety, and complications; reducing costs and readmission; and also preventing worsening of the disease and mortality. [1219202122] Unfortunately, in Iran, patients do not receive nursing consultation services and this role does not have a real status. Moreover, some nurses in Iran are not familiar with this critical and necessary role.…”