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Sutton L, Labriola M, Bognanno T, Moneer S, Ghith J, Rodriguez G, Moore L, Evuarherhe O, Morgans AK. Patient engagement in designing and publishing research in prostate cancer: a scoping review. Future Oncol 2024:1-12. [PMID: 38573132 DOI: 10.2217/fon-2023-0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 03/01/2024] [Indexed: 04/05/2024] Open
Abstract
Patients with cancer have the unique ability of being able to offer valuable insights into how cancer therapeutics may impact the overall patient experience and improve clinical outcomes. Patient engagement could therefore contribute to tailoring treatment strategies and research design according to patient needs. This study evaluated patient engagement in prostate cancer research by identifying patient input in the prostate cancer literature. We performed a keyword cluster analysis of articles from multiple databases and congresses in which patients provided input on disease management or were involved in study design, manuscript authorship or presentation of results (patient voice). In total, 112 studies were included. Patients were involved in the design of 11 studies and were credited as authors in four studies. This review suggests a lack of meaningful patient involvement in prostate cancer research and publications.
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Affiliation(s)
| | | | | | - Shelby Moneer
- ZERO - The End of Prostate Cancer, Alexandria, VA 22314, USA
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Fanshawe JB, Wai-Shun Chan V, Asif A, Ng A, Van Hemelrijck M, Cathcart P, Challacombe B, Brown C, Popert R, Elhage O, Ahmed K, Brunckhorst O, Dasgupta P. Decision Regret in Patients with Localised Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol Oncol 2023; 6:456-466. [PMID: 36870852 DOI: 10.1016/j.euo.2023.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/17/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023]
Abstract
CONTEXT Treatment choice for localised prostate cancer remains a significant challenge for patients and clinicians, with uncertainty over decisions potentially leading to conflict and regret. There is a need to further understand the prevalence and prognostic factors of decision regret to improve patient quality of life. OBJECTIVE To generate the best estimates for the prevalence of significant decision regret localised prostate cancer patients, and to investigate prognostic patient, oncological, and treatment factors associated with regret. EVIDENCE ACQUISITION We performed a systematic search of MEDLINE, Embase, and PsychINFO databases including studies evaluating the prevalence or patient, treatment, or oncological prognostic factors in localised prostate cancer patients. A pooled prevalence of significant regret was calculated with the formal prognostic factor evaluation conducted per factor identified. EVIDENCE SYNTHESIS Significant decision regret was present in a pooled 20% (95% confidence interval 16-23) of patients across 14 studies and 17883 patients. This was lower in active surveillance (13%), with little difference between those who underwent radiotherapy (19%) and those who underwent prostatectomy (18%). Evaluation of individual prognostic factors demonstrated higher regret in those with poorer post-treatment bowel, sexual, and urinary function; decreased involvement in the decision-making process; and Black ethnicity. However, evidence remains conflicting, with low or moderate certainty of findings. CONCLUSIONS A significant proportion of men experience decision regret after a localised prostate cancer diagnosis. Monitoring those with increased functional symptoms and improving patient involvement in the decision-making process through education and decision aids may reduce regret. PATIENT SUMMARY We looked at how common regret in treatment decisions is after treatment for early-stage prostate cancer and factors linked with this. We found that one in five regret their decision, with those who had experienced side effects or were less involved in the decision-making process more likely to have regret. By addressing these, clinicians could reduce regret and improve quality of life.
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Affiliation(s)
| | - Vinson Wai-Shun Chan
- Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK; Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK; Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Aqua Asif
- Division of Surgery and Interventional Sciences, University College London, London, UK; Royal Surrey NHS Foundation Trust, Surrey, UK
| | - Alexander Ng
- Division of Surgery and Interventional Sciences, University College London, London, UK; Royal Free London NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Paul Cathcart
- Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Ben Challacombe
- Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Christian Brown
- Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Rick Popert
- Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Oussama Elhage
- Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK; School of Immunology and Microbial Sciences, King's College London, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK; Department of Urology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Khalifa University, Abu Dhabi, United Arab Emirates
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Prokar Dasgupta
- Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK; MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
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Chambers DW. Toward an operational definition of shared decision making: A conceptual analysis. J Eval Clin Pract 2023; 29:1061-1067. [PMID: 36184892 DOI: 10.1111/jep.13773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/13/2022] [Accepted: 08/27/2022] [Indexed: 03/21/2023]
Abstract
RATIONALE Shared decision making has been widely advocated and evaluated in diverse ways for 4 decades. AIMS AND OBJECTIVES But there is scant evidence that it is commonly accepted by or has influence on practitioners' behaviour or that it positively affects patient health outcomes. This situation may be due in part to the absence of a commonly agreed operational definition of the construct. This is admitted in the literature and has led to multiple approaches to evaluation. METHOD An operational definition is proposed based on ethical parity among parties, sharing of mutually interacting expectations and analysis of decisions as commitment to action rather than information. RESULTS Shared decision making occurs when two autonomous and uncoerced agents both commit to actions that neither has reason to want to change based on their understanding of anticipated outcomes given the situation at hand and of the intended actions of the other party. CONCLUSION It is a broader concept than providing information regarding treatment alternatives in the office.
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Affiliation(s)
- David W Chambers
- University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
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Østergaard LD, Poulsen MH, Jensen ME, Lund L, Hildebrandt MG, Nørgaard B. Health‐related
quality of life the first year after a prostate cancer diagnosis a systematic review. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2023. [DOI: 10.1111/ijun.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Louise Dorner Østergaard
- Department of Urology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Mads Hvid Poulsen
- Department of Urology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Malene Eiberg Jensen
- The Psychiatric Research Unit at Mental Health Centre North Zealand Hillerød Denmark
- Department of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Lars Lund
- Department of Urology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Department of Nuclear Medicine Odense University Hospital Odense Denmark
| | - Birgitte Nørgaard
- Department of Public Health University of Southern Denmark Odense Denmark
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Stolz-Klingenberg C, Bünzen C, Coors M, Flüh C, Margraf NG, Wehkamp K, Clayman ML, Scheibler F, Wehking F, Rüffer JU, Schüttig W, Sundmacher L, Synowitz M, Berg D, Geiger F. Sustainability of large-scale implementation of shared decision making with the SHARE TO CARE program. Front Neurol 2022; 13:1037447. [PMID: 36504657 PMCID: PMC9726727 DOI: 10.3389/fneur.2022.1037447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/01/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction SHARE TO CARE (S2C) is a comprehensive implementation program for shared decision making (SDM). It is run at the University Hospital Schleswig-Holstein (UKSH) in Kiel, Germany, and consists of four combined intervention modules addressing healthcare professionals and patients: (1) multimodal training of physicians (2) patient activation campaign including the ASK3 method, (3) online evidence-based patient decision aids (4) SDM support by nurses. This study examines the sustainability of the hospital wide SDM implementation by means of the Neuromedical Center comprising the Departments of Neurology and Neurosurgery. Methods Between 2018 and 2020, the S2C program was applied initially within the Neuromedical Center: We implemented the patient activation campaign, trained 89% of physicians (N = 56), developed 12 patient decision aids and educated two decision coaches. Physicians adjusted the patients' pathways to facilitate the use of decision aids. To maintain the initial implementation, the departments took care that new staff members received training and decision aids were updated. The patient activation campaign was continued. To determine the sustainability of the initial intervention, the SDM level after a maintenance phase of 6-18 months was compared to the baseline level before implementation. Therefore, in- and outpatients received a questionnaire via mail after discharge. The primary endpoint was the "Patient Decision Making" subscale of the Perceived Involvement in Care Scale (PICSPDM). Secondary endpoints were an additional scale measuring SDM (CollaboRATE), and the PrepDM scale, which determines patients' perceived health literacy while preparing for decision making. Mean scale scores were compared using t-tests. Results Patients reported a significantly increased SDM level (PICSPDM p = 0.02; Hedges' g = 0.33; CollaboRATE p = 0.05; Hedges' g = 0.26) and improved preparation for decision making (PrepDM p = 0.001; Hedges' g = 0.34) 6-18 months after initial implementation of S2C. Discussion The S2C program demonstrated its sustainability within the Neuromedical Center at UKSH Kiel in terms of increased SDM and health literacy. Maintaining the SDM implementation required a fraction of the initial intensity. The departments took on the responsibility for maintenance. Meanwhile, an additional health insurance-based reimbursement for S2C secures the continued application of the program. Conclusion SHARE TO CARE promises to be suitable for long-lasting implementation of SDM in hospitals.
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Affiliation(s)
- Constanze Stolz-Klingenberg
- National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany,*Correspondence: Constanze Stolz-Klingenberg
| | - Claudia Bünzen
- National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Marie Coors
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Charlotte Flüh
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nils G. Margraf
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Kai Wehkamp
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany,Department of Medical Management, MSH Medical School Hamburg, Hamburg, Germany
| | - Marla L. Clayman
- Center for Healthcare Organization and Implementation Research (CHOIR), Veterans Administration, Bedford, MA, United States,Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Fueloep Scheibler
- National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Felix Wehking
- Department of Emergency Medicine, University Hospital Jena, Jena, Germany
| | | | - Wiebke Schüttig
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Leonie Sundmacher
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Michael Synowitz
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Friedemann Geiger
- National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany,Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
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Tabernero J, Bowling TE, Rivers J, Chari D, Ghith J, Ferdinand R, Shanahan K, Shore ND. Improving access to oncology publications for advocates and people with cancer. Cancer 2022; 128:3757-3763. [PMID: 36098654 PMCID: PMC9826100 DOI: 10.1002/cncr.34447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 01/11/2023]
Abstract
Journal articles provide reliable and current information about cancer research. This can offer hope to people with cancer and help them make decisions about their care. Here, the authors suggest ways in which different groups may help people with cancer to find, view, and understand articles. For example, journals should make articles free to view if they describe research that could change patient care. Also, clear titles and easy-to-follow summaries or videos may help people to find relevant articles and understand the main findings. It is important to explore ways to best share research with all those whose lives it may affect.
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Affiliation(s)
- Josep Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology, International Oncology Bureau‐Quiron, University of Vic‐Central University of CataloniaBarcelonaSpain
| | | | - Jamil Rivers
- METAvivor Research & SupportAnnapolisMarylandUSA
| | | | | | | | | | - Neal D. Shore
- Carolina Urologic Research CenterMyrtle BeachSouth CarolinaUSA
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7
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Brown A, Yim J, Jones S, Tan A, Callander E, Watt K, De Abreu Lourenco R, Pain T. Men's perceptions and preferences regarding prostate cancer radiation therapy: A systematic scoping review. Clin Transl Radiat Oncol 2022; 38:28-42. [PMID: 36345391 PMCID: PMC9636414 DOI: 10.1016/j.ctro.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To assess the literature on men's preferences and perceptions regarding prostate cancer radiation therapy. METHODS A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including "prostate cancer," "radiotherapy," "radiation therapy," "radiation oncology," "patient preferences," "patient perceptions" and "patient experience." The resultant studies were mapped and grouped according to the emergent themes and pathway stages. RESULTS A total of 779 titles and abstracts were screened by two independent reviewers. Fifty-two full-text studies were reviewed, with 27 eligible for inclusion. There were 4 pre-treatment, 13 during treatment and 10 post-treatment studies covering broad themes of information needs (n = 3), preferences and decisions (n = 6), general experiences (n = 8), side effects (n = 6), and support (n = 4). There were a mix of methodologies, including 11 qualitative, 14 quantitative (including four preference studies), one mixed methods and one narrative review. CONCLUSION There were only four preference studies, with the remaining 23 reporting on perceptions. Overall, there is a paucity of literature regarding patient preferences and perceptions of prostate cancer radiation therapy, particularly when considering how many clinical and technical studies are published in the area. This highlights opportunities for future research.
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Affiliation(s)
- Amy Brown
- Townsville University Hospital, Townsville, Queensland, Australia,James Cook University, Townsville, Queensland, Australia,Corresponding author at: Townsville University Hospital, PO Box 670, Queensland 4815, Australia.
| | - Jackie Yim
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia,Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Scott Jones
- Radiation Oncology Princess Alexandra Hospital Raymond Terrace, Metro South Health Service, South Brisbane, Queensland, Australia
| | - Alex Tan
- James Cook University, Townsville, Queensland, Australia,Radiation Oncology, Genesis Cancer Care, Nambour, Queensland, Australia
| | | | - Kerrianne Watt
- James Cook University, Townsville, Queensland, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Tilley Pain
- Townsville University Hospital, Townsville, Queensland, Australia,James Cook University, Townsville, Queensland, Australia
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8
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DeRosa AP, Demetres MR, McComas RR. Shared Decision-Making Among Women Diagnosed with Breast Cancer: A Phenomenological Study and Exploration into Health Literacy Education. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2022.2093086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Antonio P. DeRosa
- Patient & Community Education, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Ryan R. McComas
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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9
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Palumbo C, Bruni A, Antonelli A, Artibani W, Bassi P, Bertoni F, Borghetti P, Bracarda S, Cicchetti A, Corvò R, Gacci M, Ingrosso G, Magrini SM, Maruzzo M, Mirone V, Montironi R, Muto G, Noale M, Porreca A, Russi E, Triggiani L, Tubaro A, Valdagni R, Maggi S, Conti GN. Health-related quality of life 24 months after prostate cancer diagnosis: an update from the Pros-IT CNR prospective observational study. Minerva Urol Nephrol 2021; 74:11-20. [PMID: 33439570 DOI: 10.23736/s2724-6051.20.04032-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study analyzes patient health-related quality of life (QoL) 24-month after prostate cancer (PCa) diagnosis within the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study. METHODS Pros-IT CNR is an ongoing, longitudinal and observational study, considering a convenience sample of patients enrolled at PCa diagnosis and followed at 6, 12, 24, 36, 48 and 60 months from the diagnosis. Patients were grouped according to the treatment received: nerve sparing radical prostatectomy (NSRP), non-nerve sparing radical prostatectomy (NNSRP), radiotherapy (RT), RT plus androgen deprivation (RT plus ADT) and active surveillance (AS). QoL was measured through the Italian versions of SF-12 and UCLA-PCI questionnaires at diagnosis and at 6-12 and 24-month. The minimal clinically important difference (MCID) was defined as half a standard deviation of the baseline domain. RESULTS Overall, 1537 patients were included in the study. The decline in urinary function exceeded the MCID at each timepoint only in the NSRP and NNSRP groups (at 24 months -14.7, P<0.001 and -19.7, P<0.001, respectively). The decline in bowel function exceeded the MCID only in the RT (-9.1, P=0.02) and RT plus ADT groups at 12 months (-10.3, P=0.001); after 24 months, most patients seem to recover their bowel complaints. The decline in sexual function exceeded the MCID at each timepoint in the NNSRP, NSRP and RT plus ADT groups (at 6 months -28.7, P<0.001, -37.8, P<0.001, -20.4, P<0.001, respectively). CONCLUSIONS Although all the treatments were relatively well-tolerated over the 24 month period following PCa diagnosis, each had a different impact on QoL.
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Affiliation(s)
- Carlotta Palumbo
- Department of Urology, Maggiore della Carità Hospital, Novara, Italy
| | - Alessio Bruni
- Unit of Radiotherapy, University Hospital of Modena, Modena, Italy
| | | | | | - Pierfrancesco Bassi
- Department of Urology, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Filippo Bertoni
- Prostate Group of the Italian Association for Radiation Oncology (AIRO), Milan, Italy
| | - Paolo Borghetti
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | | | | | - Renzo Corvò
- Department of Radiation Oncology, IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Mauro Gacci
- Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Gianluca Ingrosso
- Section of Radiation Oncology, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy
| | - Stefano M Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Marco Maruzzo
- Medical Oncology Unit 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, School of Medicine, United Hospitals, Polytechnic University of the Marche Region, Ancona, Italy
| | - Giovanni Muto
- Department of Urology, Humanitas Gradenigo University Hospital, Turin, Italy
| | - Marianna Noale
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy -
| | - Angelo Porreca
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - Elvio Russi
- Department of Radiotherapy, S. Croce e Carle Teaching Hospital, Cuneo, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Andrea Tubaro
- Unit of Urology, Sant'Andrea Hospital, La Sapienza University of Rome, Rome, Italy
| | | | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
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Patient-reported Health Status, Comorbidity Burden, and Prostate Cancer Treatment. Urology 2020; 149:103-109. [PMID: 33352164 DOI: 10.1016/j.urology.2020.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine whether patient-reported health status, more so than comorbidity, influences treatment in men with localized prostate cancer. METHODS Using Surveillance, Epidemiology, and End Results data linked with Medicare claims and CAHPS surveys, we identified men aged 65-84 diagnosed with localized prostate cancer from 2004 to 2013 and ascertained their National Cancer Institute (NCI) comorbidity score and patient-reported health status. Adjusting for demographics and cancer risk, we examined the relationship between these measures and treatment for the overall cohort, low-risk men aged 65-74, intermediate/high-risk men aged 65-74, and men aged 75-84. RESULTS Among 2724 men, 43.0% rated their overall health as Excellent/Very Good, while 62.7% had a comorbidity score of 0. Beyond age and cancer risk, patient-reported health status was significantly associated with treatment. Compared to men reporting Excellent/Very Good health, men in Poor/Fair health less often received treatment (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.56-0.90). Younger men with intermediate/high-risk cancer in Good (OR 0.60, 95% CI 0.41-0.88) or Fair/Poor (OR 0.49, 95% CI 0.30-0.79) health less often underwent prostatectomy vs radiation compared to men in Excellent/Very Good health. In contrast, men with NCI comorbidity score of 1 more often received treatment (OR 1.37, 95% CI 1.11-1.70) compared to men with NCI comorbidity score of 0. CONCLUSION Patient-reported health status drives treatment for prostate cancer in an appropriate direction whereas comorbidity has an inconsistent relationship. Greater understanding of this interplay between subjective and empiric assessments may facilitate more shared decision-making in prostate cancer care.
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Nakayama K, Osaka W, Matsubara N, Takeuchi T, Toyoda M, Ohtake N, Uemura H. Shared decision making, physicians' explanations, and treatment satisfaction: a cross-sectional survey of prostate cancer patients. BMC Med Inform Decis Mak 2020; 20:334. [PMID: 33317523 PMCID: PMC7734751 DOI: 10.1186/s12911-020-01355-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
Background Hormone therapy is one option for some types of prostate cancer. Shared decision making (SDM) is important in the decision making process, but SDM between prostate cancer patients receiving hormone therapy and physicians is not fully understood. This study tested hypotheses: “Patients’ perception of SDM is associated with treatment satisfaction, mediated by satisfaction with physicians’ explanations and perceived effective decision making” and “The amount of information provided to patients by physicians on diseases and treatment is associated with treatment satisfaction mediated by patients’ perceived SDM and satisfaction with physicians’ explanations.” Methods This cross-sectional study was conducted using an online panel via a private research company in Japan. The participants in this study were patients registered with the panel who had received or were currently receiving hormone therapy for prostate cancer and physicians registered with the panel who were treating patients with prostate cancer. Measures used in this study included a nine-item Shared Decision Making Questionnaire, levels of satisfaction with physicians’ explanations and treatment satisfaction, and effective decision making for patients (feeling the choice is informed, value-based, likely to be implemented and expressing satisfaction with the choice), and a Shared Decision Making Questionnaire for Doctors. The hypotheses were examined using path analysis. Results In total, 124 patients and 150 physicians were included in the analyses. In keeping with our hypotheses, perceived SDM significantly correlated with the physicians’ explanations and perceived effective decision making for patients, and satisfaction with physicians’ explanations and perceived effective decision making for patients were both related to treatment satisfaction. Although the amount of information provided to patients was correlated with the perceived SDM, it was indirectly related to their satisfaction with physicians’ explanations. Conclusions When physicians encourage patients to be actively involved in making decisions about treatment through the SDM process while presenting a wide range of information at the start of hormone therapy, patients’ effective decision making and physicians’ explanations may be improved; consequently, the patients’ overall treatment satisfaction may be improved. Physicians who treat patients with prostate cancer may have underestimated the importance of SDM before starting hormone therapy, even greater extent than patients.
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Affiliation(s)
- Kazuhiro Nakayama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan.
| | - Wakako Osaka
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.,The Jikei University School of Medicine, School of Nursing, Tokyo, Japan
| | - Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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12
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Efficacy of a decision support intervention for reducing decisional conflict in patients with elevated serum prostate-specific antigen: A randomized controlled trial. Eur J Oncol Nurs 2020; 50:101865. [PMID: 33212360 DOI: 10.1016/j.ejon.2020.101865] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE The study purpose is to test the efficacy of a decision support intervention for reducing decisional conflict, increasing prostate biopsy knowledge, and enhancing decision self-efficacy in patients with elevated serum prostate-specific antigen. METHOD The study is based on a randomized pre-post test design. A convenience sample of men with elevated prostate-specific antigen was recruited and 1:1 randomized to the intervention and control groups. The intervention group received the decision support intervention and the control group received health education. Data were collected at the baseline and post-test by using self-reported questionnaires, including the Prostate Biopsy Knowledge Scale, the Decision Self-Efficacy Scale, the Decisional Conflict Scale, and questions regarding the prostate biopsy decision (post-test only). Data on prostate-specific antigen levels were collected from the patients' medical records. RESULTS A total of 110 patients participated in the study. At baseline, the intervention group had significantly higher knowledge scores than the control group. The analysis of the covariance model with the baseline score as a covariate was used to analyze the intervention effect. After controlling for the baseline scores, the mean differences (95% CI) between the two groups were 11.75 (11.17-12.32), 76.45 (72.52-80.37), and -23.53 (-26.31-20.20) for knowledge, decision self-efficacy, and decisional conflict, respectively. The between-group difference in willingness to accept prostate biopsy at the post-test was not statistically significant (χ2= 1.704). CONCLUSIONS The decision support intervention significantly reduced patients' decisional conflict while improving their knowledge and self-efficacy. However, the intervention did not affect patients' biopsy decision.
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French WW, Wallen EM. Advances in the diagnostic options for prostate cancer. Postgrad Med 2020; 132:52-62. [PMID: 32900250 DOI: 10.1080/00325481.2020.1822067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Over the past decade, despite the controversies surrounding prostate cancer screening, significant refinements have improved its application. PSA screening, although it has been questioned, appears to confer a mortality benefit and remains the most effective way to identify the possible presence of prostate cancer. Methods to improve the specificity of PSA screening and limit overdiagnosis of indolent cancers, including risk-stratified screening regimens, are currently being utilized. Certain imaging modalities, such as multiparametric MRI, have proven to be excellent adjuncts providing improved risk stratification and the ability for targeted biopsies; however, concerns over variability in interpretation and generalizability persist. A number of novel biomarkers have become available with nearly all demonstrating the ability to improve upon the specificity of PSA screening; however, optimal timing, direct comparisons, and usefulness in conjunction with imaging modalities remain to be elucidated. With the improvement in testing options and recognition of the risk/benefit ratio for men undergoing screening for prostate cancer, the increasing role of shared decision making in the process is emphasized.
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Affiliation(s)
- William W French
- Department of Urology, University of North Carolina Medical Center , Chapel Hill, NC, United States
| | - Eric M Wallen
- Department of Urology, University of North Carolina Medical Center , Chapel Hill, NC, United States
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Wang F, Huang L, Zhang H, Jiang H, Chang X, Chu Y, Wang Z, Zhang X. Factor Analysis and Psychometric Properties Adaption of Chinese Version of the Decisional Engagement Scale (DES-10). Patient Prefer Adherence 2020; 14:2027-2034. [PMID: 33122896 PMCID: PMC7588833 DOI: 10.2147/ppa.s266687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/02/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To translate and validate the DES-10 into Chinese and adapt the DES-10 among Chinese prostate cancer patients. To explore the impact of demographic data on the SDM of Chinese prostate cancer patients. METHODS Data were collected from December 2019 to January 2020 from four hospitals among prostatic cancer patients in Henan Province, by convenience sampling method. A demographic questionnaire, DES-10, and 9-item Shared Decision Making Questionnaire (SDM-Q-9) were administered. The exploratory and confirmatory factor analysis was carried out to test the content, construct, reliability, and concurrent validity of the translated DES-10. Then, Pearson's correlation, t-test, and analysis of variance were used to test the demographic difference of DES-10. RESULTS A total of 380 prostatic cancer patients completed the survey (96% response rate). The total score of DES-10 was 71.16±17.14. The Cronbach's ɑ coefficient was 0.87. Single factor structure was confirmed by exploratory factor analysis (explaining 50.14% of the variance). Model fitting indexes (RMSEA=0.07, CMIN/DF=2.92) were acceptable. The DES-10 scale showed good validity with the SDM-Q-9 as the criterion. Age, marital status, homeplace, and household monthly income could affect the shared decision-making of prostatic cancer patients. CONCLUSION The DES-10 was demonstrated to be a valid and reliable scale to assess the prostatic cancer patient's engagement in health care decision-making. And it is culturally appropriate for use in China. The influence of age, marital status, homeplace, and household monthly income should be considered in promoting patients' participation in shared decision-making.
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Affiliation(s)
- Feijie Wang
- Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou University Peoples Hospital, Zhengzhou, Henan450003, People’s Republic of China
| | - Lijie Huang
- Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou University Peoples Hospital, Zhengzhou, Henan450003, People’s Republic of China
| | - Hongmei Zhang
- Nursing Department, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan450003, People’s Republic of China
- Correspondence: Hongmei Zhang Email
| | - Hongxia Jiang
- Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou University Peoples Hospital, Zhengzhou, Henan450003, People’s Republic of China
| | - Xiaoxia Chang
- Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou University Peoples Hospital, Zhengzhou, Henan450003, People’s Republic of China
| | - Yinping Chu
- Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou University Peoples Hospital, Zhengzhou, Henan450003, People’s Republic of China
| | - Zhixia Wang
- Gastrointestinal Surgery, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan450003, People’s Republic of China
| | - Xiaoli Zhang
- Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou University Peoples Hospital, Zhengzhou, Henan450003, People’s Republic of China
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