Empowerment of men newly diagnosed with prostate cancer

Abstract

The purpose of this study was to explore the hypothesis that assisting men with prostate cancer to obtain information would enable them to assume a more active role in treatment decision making and decrease their levels of anxiety and depression. Respondents were recruited from one community urology clinic in Winnipeg, Manitoba. Sixty newly diagnosed men were randomly assigned to receive either a self-efficacy information intervention that consisted of a written information package with discussion, a list of questions they could ask their physician, and an audiotape of the medical consultation (n = 30), or a written information package alone (n = 30). Men completed measures of preferred decisional role as the pretest; anxiety and depression before the intervention, and at 6 weeks post-intervention; and assumed decisional role at 6 weeks post-intervention. Results demonstrated that men in the intervention group assumed a significantly more active role in treatment decision making, and had lower state anxiety levels at 6 weeks. Levels of depression were similar for both groups at 6 weeks. This group of older men do want to be informed and participate in medical decisions. Further efforts are required to evaluate the efficacy of such an intervention in other community urology clinics.

Treatment decision making in prostate cancer: Patients’ participation in complex decisions

“…Nearly 80% of the patients indicated they had selected their treatment by themselves or in collaboration with their physician. This level of participation is comparable to findings from previous research [8,18]. The fact that participation in TDM was related to stage of disease (and treatment) may be explained by the fact that when metastases are discovered, few other options remain except for hormone treatment.…”

“…In TDM studies three types of decision making are usually distinguished [e.g., 8,9]: (a) active or autonomous decision making, indicating the patient is solely responsible for the decision; the physician's preferences are not prominent and his role is that of a counsellor; (b) collaborative or shared decision making, referring to the situation where both patient and physician share responsibility for the decision making; (c) a passive role of the patient implies that the patient is not involved in decision making. In this case the physician reviews the treatment options and makes the decision.…”

Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects

“…43,44 Providing patients with information in a way that was meaningful to them reportedly resulted in significant benefits, including an enhanced sense of control, reduced anxiety and depression, improved communication with health care providers, and greater satisfaction with care. 9,45,46 …”

“…6 Other studies that focus on the decision-making or symptom management aspects of the illness trajectory appear to be marked by design flaws, 7 one treatment modality, 8 small sample sizes, and noninclusion of minority men. 9,10 The lack of psychoeducational interventions for men with prostate carcinoma is surprising considering the life-altering nature of treatment. After undergoing either surgery or radiation therapy for prostate carcinoma, patients experience a variety of symptoms, including urinary incontinence, fatigue, bowel dysfunction, and impotence.…”

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

“…Several studies confirm that shared decision making is applied in practice; 45,[53][54][55] however, it appears that discrepancies exist between the preferred role and the actual role of patients in the decision-making process. 56 Men are becoming more active in the decision-making process, as the study by Davison and Degner 57,58 (32% of men wanting their physician to make the final decision, versus 58% of men in a similar conducted study 5 years earlier) shows. However, in general it is still the doctor who sets the agenda and who decides how much information is presented to the patient.…”