title: Treatment decision-making by men with localized prostate cancer: the influence of personal factors.
abstract: OBJECTIVE
  For many men with localized prostate cancer, there is no definite answer or unequivocal choice regarding treatment modality. This high-stakes treatment decision is made in the context of great uncertainty. The purpose of this study is to systematically document meaningful and relevant aspects of treatment decision-making reported by men with localized prostate cancer.
  
  
  METHODS
  Focus groups and individual interviews were conducted with 44 men who were within 6 months of a diagnosis of localized prostate cancer. Using content analysis and grounded theory analytic techniques, major aspects and processes of men's treatment decision making are identified and described.
  
  
  RESULTS
  The participants reported their experiences beginning with influential personal history factors, followed by detailed descriptions of information gathering and the important influence of expected treatment outcomes and other individuals' cancer histories and/or shared opinions. Twenty of the 44 (45%) participants relied heavily on the influence of another's opinion or history to finalize a decision, yet only 10 of the 44 (22.7%) reported this individual to be their physician. A common process, "making the best choice for me" was explicated.
  
  
  CONCLUSIONS
  Clinicians assume that men are making rational treatment decisions based on reliable information, yet this study documents a different reality. Patient education about medical therapies and the patients' own medical factors is not enough. A clinic visit dialogue that brings personal factors to the conversation along with medical factors can guide a man to making his "best choice" for localized prostate cancer.
authors.affiliation: School of Nursing, University of Seattle, Department of Urology, University of Washington Medical Center, Seattle, Washington, USA. donnalb@u.washington.edu
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
authors.forename: William J
authors.initials: WJ
authors.lastname: Ellis
authors.forename: Nancy Fugate
authors.initials: NF
authors.lastname: Woods
authors.forename: Christina
authors.initials: C
authors.lastname: Schwien
authors.forename: Kristin H
authors.initials: KH
authors.lastname: Mullen
authors.forename: Claire
authors.initials: C
authors.lastname: Yang
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy