Understanding Advanced Prostate Cancer Decision Making Utilizing an Interactive Decision Aid

Jones, Randy; Hollen, Patricia J.; Weiss, Geoffrey R.; Song, Daniel Y.; Sims, Terran; Petroni, Gina R.

doi:10.1097/ncc.0000000000000442

Cited by 20 publications

(16 citation statements)

References 37 publications

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“…Similar to a study in localized prostate cancer 19 and a study of patients with advanced prostate cancer, 20 we found that most patients relied heavily on their physician’s recommendations. However, another study in localized disease found that patients relied more on the stories and experiences of others, particularly men who have been previously treated for localized prostate cancer.…”

Section: Discussionsupporting

confidence: 82%

“…We identified many similar treatment considerations among men with mPCa, highlighting significant overlap in what patients consider while making treatment decisions for prostate cancer across the disease continuum. Similar to a study in localized prostate cancer 19 and a study of patients with advanced prostate cancer, 20 we found that most patients relied heavily on their physician's recommendations. However, another study in localized disease found that patients relied more on the stories and experiences of others, particularly men who have been previously treated for localized prostate cancer.…”

supporting

confidence: 81%

“…This may ultimately improve the quality of treatment decisions and outcomes for mPCa. 20,30,35 Patient Preference and Adherence 2020:14 submit your manuscript | www.dovepress.com…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

<p>What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study</p>

Oswald¹,

Schumacher²,

Gonzalez³

et al. 2020

PPA

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Objective: Metastatic prostate cancer (mPCa) patients often make complicated treatment decisions, yet decision aids to facilitate shared decision-making for mPCa are uncommon. To inform the development of patient-centered mPCa decision aids, we examined what mPCa survivors considered most important when making treatment decisions. Methods: Using an exploratory sequential approach, we conducted three focus groups with 14 advanced prostate cancer survivors (n=5, n=3, n=6 in each group) to identify considerations for making treatment decisions. Focus groups were audio-recorded and transcribed, and we identified qualitative themes. We then developed a quantitative survey to assess the importance of each theme and administered the survey to mPCa survivors (N=100). We used relative frequencies to determine the most strongly endorsed items and chi-squared and Fisher's exact tests to assess associations with participant characteristics. Results: Focus groups yielded 11 themes, and the resulting survey included 20 items. The most strongly endorsed mPCa treatment considerations were: relying on physician's treatment recommendations (79% strongly agree); wanting to feel well enough to spend quality time with loved ones (72% strongly agree); the importance of dying in a manner consistent with one's wishes (70% strongly agree); hoping to eliminate cancer completely (68% strongly agree); and optimizing treatment efficacy (65% strongly agree). Age, race, marital status, employment status, and self-reported health were related to how strongly men endorsed various considerations for mPCa treatment decision-making. Conclusion: We identified multiple considerations that mPCa survivors appraised when making treatment decisions. These data may inform the development of patient-centered decision aids for mPCa.

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Section: Discussionsupporting

confidence: 82%

supporting

confidence: 81%

See 1 more Smart Citation

<p>What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study</p>

Oswald¹,

Schumacher²,

Gonzalez³

et al. 2020

PPA

View full text Add to dashboard Cite

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“…Sexuality, masculinity and marital relationship were important issues; the need to encourage communication about these essential areas, throughout the trajectory, was emphasised repeatedly. Due to the complexity and several new treatments, the diagnostic and treatment phase can be complicated and disjointed, involving difficult treatment decisions and multiple care interventions by different HCPs (Jones et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

The value of information and support; Experiences among patients with prostate cancer

Aunan

Wallgren

Hansen

2021

Journal of Clinical Nursing

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Aims and objectives To explore and analyse prostate cancer survivors` experiences and critical reflections of information received during their cancer trajectory. Background Prostate cancer is one of the most prevalent cancers in men worldwide. Treatment causes side effects such as urinary incontinence, bowel changes and erection problems influencing sex life and manhood. Cancer pathways are designed to give patients and their relatives a predictable and as stress‐free as possible treatment trajectory and minimise waiting time. Design Qualitative, explorative research design. Methods Focus groups with 16 prostate cancer survivors after having participated in an educational programme. The COREQ checklist was followed to ensure rigour in the study. Results The main theme, ‘Help me stay in control’, and three subthemes, ‘To be met with interest and support, enough knowledge to understand what is happening and a plan to build the new life on’, emerged from qualitative analysis and highlighted the participants’ need for information and support, specially scheduled at critical times in the treatment trajectory: the diagnostic phase, the treatment phase and the life after treatment. They also highlighted the need for empathy and interest from healthcare professionals and highlighted the need for arenas to discuss vulnerable topics. Contact with peers was perceived as supportive and encouraging. Conclusion Healthcare professionals must support prostate cancer survivors with empathy, interest and information tailored to their needs in three different phases. Continuity in information flow may increase trust and satisfaction among the prostate cancer survivors. Relevance to clinical practice PCa patients’ need for information varied at critical times in their treatment trajectory. HCP should meet them with empathy and interest to be able to tailor their need for information and support.

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“…Still, it has been shown that men with mCRPC lack enough information about the treatments and their possible impact of them on their life (Jenkins et al, 2019). Further, QoL has been shown to be more important to men with mCRPC than extending life expectancy with the risk of experiencing debilitating treatment complications (Jones et al, 2018). Considering the often long course of the disease, the severe symptom burden and the decline of QoL in the advanced stages, it has been argued that palliative care might be especially suitable for men with PC, even in conjunction with life-prolonging treatments (Sanford et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer – An interview study

Doveson

Holm

Axelsson

et al. 2020

European Journal of Oncology Nursing

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Several life-prolonging treatment options have recently become available for metastatic castrationresistant prostate cancer. However, research regarding patient experiences while undergoing these treatments is scarce. The aim was to explore the perspectives of men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer. Method: Qualitative interviews were conducted with 16 men as they were starting, undergoing or had completed their first life-prolonging treatment. Interpretive description was used for analysis. Results: The results illuminate the complexity of facing life-prolonging treatment, with interlaced dimensions beyond just the outcome, and where the men described other dimensions of their lives in relation to the treatment. The results are presented as 4 themes; Considering treatment when the remainder of life is at stake, Preparing for the life-prolonging treatment after deciding to go through with it, Considering the prospect of the life-prolonging treatment not being successful and Reflecting on death and dying in the light of a life-limiting illness. Conclusions: The quality and content of the remainder of life are central for men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer. This is important when weighing desired treatment outcomes against side effects, and when reflecting upon whether going through with treatment would be worth it or not. The results illuminate the importance of encouraging men at this stage to express expectations, hopes and fears regarding the treatment and the future when considering life-prolonging treatments. Nurses working with these patients are important in the decision-making process and in evaluating treatments, to detect needs for interventions.

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Understanding Advanced Prostate Cancer Decision Making Utilizing an Interactive Decision Aid

Abstract: Decision aids assist patients, decision partners, and healthcare providers make satisfying treatment decisions that affect quality/quantity of life. These findings are important for understanding the experiences of patients who have to make difficult decisions.

Cited by 20 publications

References 37 publications

<p>What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study</p>

<p>What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study</p>

The value of information and support; Experiences among patients with prostate cancer

Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer – An interview study

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