scholarly journals Sources of Information for Learning and Decision-Making in Men With Localized Prostate Cancer

2020 ◽  
Vol 14 (5) ◽  
pp. 155798832094546 ◽  
Author(s):  
Sumedha Chhatre ◽  
Marsha N. Wittink ◽  
Joseph J. Gallo ◽  
Ravishankar Jayadevappa
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Decision Making ◽  
Cancer Patients ◽  
Information Seeking ◽  
Localized Prostate Cancer ◽  
Care Providers ◽  
Sources Of Information ◽  
Patient Centered ◽  
Information Carrier

Information seeking is essential for effective patient-centered decision-making. However, prostate cancer patients report a gap between information needed and information received. The importance of different information sources for treatment decision remains unclear. Thus, using the Comprehensive Model of Health Information (CMIS) framework, we assessed the antecedent factors, information carrier factors, and information-seeking activities in localized prostate cancer patients. Data were collected via semistructured one-on-one, interviews and structured survey. Men with localized prostate cancer were recruited from two urban health-care centers. Following the interview, participants completed a survey about sources that were helpful in learning about prostate cancer treatment and decision-making. The interviews were audio-recorded, transcribed, and subjected to a thematic analysis using NVivo 10. Fifty localized prostate cancer survivors completed the interviews and surveys. Important antecedent factors that were observed were age, marital status, uncertainty, anxiety, caregiver burden, and out-of-pocket expenses. We identified complexity, magnitude, and reliability as information carrier characteristics. Preferred sources for information were health providers, medical websites, and pamphlets from the doctor’s office. These sources were also perceived as most helpful for decision-making. Urologists, urological oncologists, and radiation/radiation oncologists were important sources of information and helpful in decision-making. Prostate cancer patients obtained information from multiple sources. Most prostate cancer patients make patient-centered choices by incorporating personal factors and medical information. By considering factors that influence patients’ treatment decisions, health-care providers can enhance the patient-centeredness of care. Multiple strategies and interventions are necessary for disseminating valid, reliable, and unbiased information to prostate cancer patients to facilitate informed decisions.

scholarly journals Patient-Centered Approach to Develop the Patient’s Preferences for Prostate Cancer Care (PreProCare) Tool

2019 ◽  
Vol 4 (1) ◽  
pp. 238146831985537 ◽  
Author(s):  
Ravishankar Jayadevappa ◽  
Sumedha Chhatre ◽  
Joseph J. Gallo ◽  
S. Bruce Malkowicz ◽  
J. Sanford Schwartz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Focus Groups ◽  
Cancer Patients ◽  
Cancer Care ◽  
Assessment Tool ◽  
Preference Assessment ◽  
Localized Prostate Cancer ◽  
Advisory Group ◽  
Patient Centered

Objectives. To describe the development of our Patient Preferences for Prostate Cancer Care (PreProCare) tool to aid patient-centered treatment decision among localized prostate cancer patients. Methods. We incorporated patient and provider experiences to develop a patient preference elicitation tool using adaptive conjoint analysis. Our patient-centered approach used systematic literature review, semistructured patient interviews, and provider focus groups to determine the treatment attributes most important for decision making. The resulting computer-based PreProCare tool was pilot tested in a clinical setting. Results. A systematic review of 56 articles published between 1995 and 2015 yielded survival, cancer recurrence, side effects, and complications as attributes of treatment options. We conducted one-on-one interviews with 50 prostate cancer survivors and 5 focus groups of providers. Patients reported anxiety, depression, treatment specifics, and caregiver burden as important for decision making. Providers identified clinical characteristics as important attribute. Input from stakeholders’ advisory group, physicians, and researchers helped finalize 15 attributes for our PreProCare preference assessment tool. Conclusion. The PreProCare tool was developed using a patient-centered approach and may be a feasible and acceptable preference clarification intervention for localized prostate cancer patients. The PreProCare tool may translate into higher participant engagement and self-efficacy, consistent with patients’ personal values.

scholarly journals African American Women’s Involvement in Promoting Informed Decision-Making for Prostate Cancer Screening Among Their Partners/Spouses

2018 ◽  
Vol 12 (4) ◽  
pp. 884-893 ◽  
Author(s):  
Jennifer D. Allen ◽  
Ifedayo C. Akinyemi ◽  
Amanda Reich ◽  
Sasha Fleary ◽  
Shalini Tendulkar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Decision Making ◽  
African American ◽  
Cancer Screening ◽  
African American Men ◽  
Prostate Cancer Screening ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Care Providers

Routine prostate cancer screening is not recommended but African American men who are at higher risk for the disease should be offered the opportunity for shared decision-making with their health-care providers. This qualitative study sought to better understand the potential role of women in educating their male spouses/partners about prostate cancer screening. Nine focus groups were conducted ( n = 52). Women were recruited from a variety of community venues. Those eligible were African American and married to or in a partnership with an African American male age ≥ 45. Women provide numerous types of support to their male partners in an effort to facilitate participation in preventive health care. While women agreed that they would like to educate their partners about prostate cancer screening, they had little information about screening guidelines or the potential harms and limitations. The current findings suggest that women are eager information-seekers and can disseminate information to men and facilitate their efforts to make more informed decisions about prostate cancer screening. Women should be included in educational interventions for to promote informed decision-making for prostate cancer screening.

Associations between patient knowledge of others' experiences and treatment choice in men with localized prostate cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6578-6578
Author(s):  
Aaron J. Katz ◽  
Ying Cao ◽  
Xinglei Shen ◽  
Deborah Usinger ◽  
Sarah Walden ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
North Carolina ◽  
Cancer Patients ◽  
Treatment Options ◽  
Population Based ◽  
Treatment Choice ◽  
Localized Prostate Cancer ◽  
The North ◽  
Patient Reported

6578 Background: Men with localized prostate cancer must select from multiple treatment options, without one clear best choice. Consequently, personal factors, such as knowing other prostate cancer patients who have undergone treatment, may influence patient decision-making. However, associations between knowledge about others’ experiences and treatment decision-making among localized prostate cancer patients has not been well characterized. We used data from a population-based cohort of localized prostate cancer patients to examine whether patient-reported knowledge of others’ experiences is associated with treatment choice. Methods: The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) is a population-based cohort of localized prostate cancer patients enrolled from 2011-2013 throughout the state of North Carolina in collaboration with the North Carolina Central Cancer Registry. All patients were enrolled prior to treatment and followed prospectively. Patient decision-making factors including knowledge of others’ experiences with prostate cancer treatment options were collected through patient report. Patient treatment choice was determined through medical record abstraction and cancer registry data. Results: Among 1,202 patients, 17% reported knowing someone who pursued active surveillance (AS) while 28%, 46%, and 59% reported knowing someone who received brachytherapy, external beam radiation (EBRT), or radical prostatectomy (RP), respectively; 26% underwent AS, 9% brachytherapy, 21% EBRT, and 39% RP as their initial treatment. In unadjusted analyses, patients with knowledge of others’ experiences with brachytherapy, EBRT or RP had more than twice the odds of receiving that treatment compared to patients who did not. Knowledge of others’ experience with AS was not associated with choice to undergo AS. Multivariable analysis adjusting for age, race, risk group, and patient-reported goals of care showed knowledge of others’ experiences with brachytherapy (OR 4.60, 95% confidence interval [CI] 2.76 to 7.68), EBRT (OR 2.38, 95% CI 1.69 to 3.34), or RP (OR 4.02, 95% CI 2.84 to 5.70) was significantly associated with odds of receiving that treatment. The odds of receiving a particular treatment option were further increased among patients who reported knowing someone who had a “good” experience with the treatment in question. Conclusions: This is the first population-based study to directly demonstrate the impact of a patient’s knowledge of others’ experiences on treatment choice in prostate cancer. These data provide a new consideration to clinicians in their counseling of patients with newly diagnosed prostate cancer, and also impacts research into the informed decision-making process for this disease.

scholarly journals Shared decision-making in food allergy management

2020 ◽  
Vol 2 (1) ◽  
pp. 124-127
Author(s):  
Meera Patrawala ◽  
Gerald Lee ◽  
Brian Vickery
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Food Allergy ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Decision Aids ◽  
Shared Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Evidenced Based

Historically, the role of the health-care provider in medical practice has been primarily paternalistic by offering information, compassion, and decisive views with regard to medical decisions. This approach would exclude patients in the decision-making process. In a shift toward more patient-centered care, health-care providers are routinely encouraged to practice shared decision making (SDM). SDM uses evidence-based information about the options, elicitation of patient preferences, and decision support based on the patient’s needs with the use of decision aids or counseling. Although there are well-known benefits of SDM, including improvements in psychological, clinical, and health-care system domains providers have found it challenging to apply SDM in everyday clinical practice. In allergy, we have a unique role in the treatment of children and adults, and SDM should be applied appropriately when engaging with these specific groups. There are many situations in which there is not a clear best option (food allergy testing, food introduction and challenges, and immunotherapy). Therefore, decision aids specific to our field, coupled with evidenced-based information that ultimately leads to a decision that reflects the patient’s values will make for a vital skill in practice. In this article, we defined SDM, the benefits and barriers to SDM, unique situations in SDM, and approach to SDM in food allergy.

Development, and Evaluation of a Decision Aid to Support Patients’ Participa-tory Decision-making on Tumor-specific and Palliative Therapy in Advanced Cancer Patients: A Study Protocol. (Preprint)

2020 ◽  
Author(s):  
Katsiaryna Laryionava ◽  
Jan Schildmann ◽  
Michael Wensing ◽  
Ullrich Wedding ◽  
Bastian Surmann ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Health Care Providers ◽  
Study Protocol ◽  
Care Providers ◽  
Advanced Cancer Patients ◽  
Design Study

BACKGROUND To support advanced cancer patients, for whom standard therapy is no longer avail-able, and their oncologists in therapy decisions, we aim to develop a decision-making aid (DA) in a multi-phased bicentric study. The DA aims to help patients to better un-derstand risks and benefits of available treatment options including the options of standard palliative care, off-label drug use within an individual treatment plan and involvement in clinical trials. OBJECTIVE This study protocol outlines the development and testing of a DA in a pre-post design study targeting at a heterogeneous population of advanced cancer patients. METHODS In phase I, The DA will be developed after of decisional needs of patients and views of health care providers based on face-to face interviews and focus groups discus-sions. Subsequently, the DA will be alpha-tested and redrafted, as necessary, in phase II. In phase III, the DA will be (1) beta-tested with patients and oncologists and (2) assessed by experts. In the last project phase, we will run a pre-post design study with n= 70 doctor-patient-encounters to access improvements on primary study outcome, i.e. patients’ level of decisional conflict. In addition, the user ac-ceptance will be tested. RESULTS Interviews with cancer patients, oncologists and health care providers have been completed. CONCLUSIONS A unique feature of this study is the development of a DA for patients with different types of advanced cancer, which covers a wide range of topics relevant for patients near the end of life such as forgoing cancer-specific therapy and patients’ inclusion in clinical trials. CLINICALTRIAL NCT04606238 https://clinicaltrials.gov/ct2/show/NCT04606238

Patient Satisfaction Influenced by Interpersonal Treatment and Communication for African American Men

2012 ◽  
Vol 6 (5) ◽  
pp. 409-419 ◽  
Author(s):  
Angelo D. Moore ◽  
Jill B. Hamilton ◽  
George J. Knafl ◽  
P.A. Godley ◽  
William R. Carpenter ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
North Carolina ◽  
African American ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
African American Men ◽  
Care Providers ◽  
Patient Centered ◽  
The North

The purpose of this study was to determine if a particular set of health behaviors of health care providers and African American men (AAM) influence patient satisfaction from the AAM’s perspective. This descriptive, correlational study consisted of 505 AAM in North Carolina diagnosed with prostate cancer and enrolled in the North Carolina–Louisiana Prostate Cancer Project (PCaP). Analyses consisted of bivariate analyses and multiple regression. Patient-to-provider communication, interpersonal treatment, and provider-to-patient communication accounted for 45% ( p ≤ .0001) of the variability in patient satisfaction. Interpersonal treatment (provider focusing on the patient) explained the greatest amount ( F = 313.53, R2 = .39) of patient satisfaction. Since interpersonal treatment focuses on the patient and demonstrated to be the strongest predictor in patient satisfaction, it is noteworthy to consider the emphasis that should be placed on patient-centered care. In addition, knowing important variables positively affecting patient satisfaction provides useful information for developing appropriate interventions to improve AAM health care experiences.

Reflections on Shared Decision Making

2018 ◽  
Vol 159 (5) ◽  
pp. 809-810
Author(s):  
John J. Chi
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Patient Adherence ◽  
Medical Decision ◽  
Shared Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Values And Beliefs

Decisions about medical and surgical treatment can be complex—even for health care providers, who can struggle with which treatment option to offer their patients. In the current landscape of patient-centric value-based health care, the need for appropriate medical decision making to maximize treatment outcomes is evermore important. Shared decision making is a process in which clinicians and patients make decisions together using the best available evidence while accounting for the patients’ values and beliefs. A patient-centered approach has been associated with improved patient satisfaction, clinical outcomes, and patient adherence to treatment. Only by taking a collaborative care approach among patients, physicians, and caregivers can we hope to deliver the best possible care and improve our outcomes for each and every patient.

scholarly journals Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom

2021 ◽  
pp. 0272989X2110580
Author(s):  
Ken Resnicow ◽  
Delwyn Catley ◽  
Kathy Goggin ◽  
Sarah Hawley ◽  
Geoffrey C. Williams
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Coping Resources ◽  
Patient Needs ◽  
Shared Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Theoretical Perspectives

Applying both theoretical perspectives and empirical evidence, we address 2 key questions regarding shared decision making (SDM): 1) When should SDM be more patient driven, and when should it be more provider driven? and 2) Should health care providers match their SDM style/strategy to patient needs and preferences? Self-determination theory, for example, posits a distinction between autonomy and independence. A patient may autonomously seek their health care provider’s input and guidance, perhaps due to low perceived competence, low coping resources, or high emotional arousal. Given their need state, they may autonomously require nonindependence. In this case, it may be more patient centered and need supportive to provide more provider-driven care. We discuss how other patient characteristics such as personality attributes, motivational state, and the course of illness and other parameters such as time available for an encounter may inform optimal provider decision-making style and strategy. We conclude that for some types of patients and clinical circumstances, a more provider-driven approach to decision making may be more practical, ethical, and efficacious. Thus, while all decision making should be patient centered (i.e., it should consider patient needs and preferences), it does not always have to be patient driven. We propose a flexible model of SDM whereby practitioners are encouraged to tailor their decision making behaviors to patient needs, preferences, and other attributes. Studies are needed to test whether matching decision-making behavior based on patient states and traits (i.e., achieving concordance) is more effective than simply providing all patients with the same type of decision making, which could be tested using matching/mismatching designs.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

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