ASSESSING INFORMATION AND TREATMENT DECISION-MAKING NEEDS OF PATIENTS WITH LOCALLY RECURRENT PROSTATE CANCER

Abstract

<p><strong>Introduction. </strong>Treatment decisions for locally recurrent prostate cancer are difficult due to the number of available treatment options, varied evidence about their effectiveness and differences in side effects. It has been shown that decision aids improve information delivery and patient confidence in treatment decision-making.</p> <p><strong>Purpose.</strong> The purpose of this study was to identify and describe the decisional support needs of men with locally recurrent prostate cancer.</p> <p><strong>Methods.</strong> A two-phase descriptive needs assessment study employing both quantitative and qualitative methods was conducted to identify and describe the treatment decision-making needs of men with recurrent prostate cancer. Through a two-round Delphi process in Phase 1, physician consensus on treatment options for the decision aid was established. Phase 2 involved patient interviews to determine treatment decision-making needs.</p> <p><strong>Results.</strong> Oncologists and patients agreed that the treatment decision-making process took time, and may take several months. Some patients described feelings of regret and/or uncertainty about their treatment decision. Individualized patient needs for information and support were recognized. Key barriers to effective treatment decision-making included information overload and lack of access to unbiased information sources. Establishing a centralized information resource such as nurse-led information sessions was recommended by patients.</p> <p><strong>Conclusions.</strong> Treatment decision-making is time consuming for oncologists and patients. Despite these efforts, patients report unmet information needs and are not always confident in their treatment decision. Time efficient and effective ways of improving patient confidence in treatment decision-making, as well as implications for nursing practice and future research are discussed.</p>