Factors that predict treatment choice and satisfaction with the decision in men with localized prostate cancer.
OBJECTIVE
Men diagnosed with localized prostate cancer (LPC) often have the opportunity to participate in the treatment choice. The purpose of this study was to evaluate relationships between influential factors on treatment choice and the decision-related outcomes of decisional conflict and satisfaction.


METHODS
This report presents data from 260 men diagnosed with LPC who were identified by their clinicians as having a choice of treatments. Men completed questionnaires at home within 2 weeks of the informational clinic visit with the clinician, but before treatment. The respondent sample had a mean age of 63.2 years (standard deviation, 8.1 years); the majority were married/partnered (82.7%), working (51.5%), white (93.8%), and educated at the collegiate level (83.8%). Personal factors (information, influential people, and outcomes), treatment choice, and decisional conflict and satisfaction with the decision (SWD) were queried. Relationships between all variables and the outcomes, SWD, and treatment choice were explored using exhaustive chi(2) automatic interaction detector.


RESULTS
The strongest predictor partition variable for SWD was the subscale "factors contributing to uncertainty" (adjusted P < 0.0001) followed by the Trait Anxiety score (adjusted P = 0.0388). The strongest predictive partition for the actual treatment choice was age group (adjusted P < 0.0001), followed by interacting marital status (adjusted P = 0.0003), influence of the urologist (adjusted P = 0.0008), and use of the Internet (adjusted P = 0.0479). Men with LPC were more satisfied with their treatment choice when they reported fewer uncertainty factors; these are factors mainly relevant to information needed to understand the pros and cons and to make a decision. Consistent with this finding for treatment choice is the use of the Internet, though this factor interacted with age, the influence of their surgeon, and marital status.


CONCLUSIONS
This study suggests that personally meaningful information communicated between patients and clinicians is paramount.
Berry
Donna L
DL
University of Washington, Seattle, WA 98195-7266, USA. donnalb@u.washington.edu
Ellis
William J
WJ
Russell
Kenneth J
KJ
Blasko
John C
JC
Bush
Nigel
N
Blumenstein
Brent
B
Lange
Paul H
PH
D000368:Aged; D003710:Demography; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires