Men's theories about benign prostatic hyperplasia and prostate cancer following a benign prostatic hyperplasia decision aid.
OBJECTIVE
To use qualitative methods to explore audiotape evidence of unanticipated confusion between benign prostatic hyperplasia (BPH) and prostate cancer in using a videotape BPH treatment decision aid (DA).


METHODS
Qualitative analysis of semi-structured interviews and surveys originally collected to study men's interpretation of a DA.


METHODS
Community sample of college and noncollege educated African American and white men (age> or =50; n=188).


METHODS
Transcript analysis identified themes in men's comments about BPH and cancer. Surveys measured BPH general and prostate cancer-specific knowledge, literacy (Short Test of Functional Health Literacy in Adults), BPH symptoms, and demographics.


RESULTS
In transcript analysis, 18/188 men spontaneously talked about BPH and cancer as being related to each other, despite explicit statements to the contrary in the video. Survey data suggest that up to 126/188 men (67%) persisted in misconceptions even after viewing the DA video. Three themes were identified in the transcripts: (1) BPH and cancer are equated, (2) BPH surgery is for the purpose of removing cancer, and (3) BPH leads to cancer.


CONCLUSIONS
Overall knowledge increases with DA use may mask incorrect theories of disease process. Further research should identify decision support designs and clinical counseling strategies to address persistence of beliefs contrary to new information presented in evidence-based DAs.
Holmes-Rovner
Margaret
M
Department of Medicine and Center for Ethics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA. mholmes@msu.edu
Price
Chrystal
C
Rovner
David R
DR
Kelly-Blake
Karen
K
Lillie
Janet
J
Wills
Celia
C
Bonham
Vence L
VL
D001741:Black or African American; D003657:Decision Making; D004522:Educational Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000628:therapy*; D011471:Prostatic Neoplasms / Q000628:therapy*; D014741:Video Recording; D044465:White People