Managing uncertainty about treatment decision making in early stage prostate cancer: a randomized clinical trial.
OBJECTIVE
The purpose of this study was to examine the effects of a theory-based decision-making uncertainty management intervention (DMUMI) providing newly diagnosed prostate cancer patients with information, communication skills and personally designed prompts.


METHODS
A randomized clinical trial was conducted using a 3x2 design with intervention and control groups including both Caucasian and African-American men. General linear mixed models were used to compare intervention groups over time.


RESULTS
Significant main effects for the treatment groups were found for uncertainty management (cancer knowledge, problem-solving, and patient-provider communication), medical communication competence, number and helpfulness of resources for information, and decisional regret.


CONCLUSIONS
The intervention was effective in uncertainty management for Caucasian and African-American men, specifically in preparing competent patients with improved knowledge, problem-solving skills, information resources, and communication skills. Using the Uncertainty in Illness Theory, specific skills were selected with a focus on the antecedents of uncertainty.


CONCLUSIONS
In the treatment decision-making context, patients and supportive others need information about disease, treatment options and side effects but they also need communication skills training prior to the treatment decision consultation.
Mishel
Merle H
MH
School of Nursing, CB# 7460, University of NC at Chapel Hill, NC 27599, USA. mishel@email.unc.edu
Germino
Barbara B
BB
Lin
Lin
L
Pruthi
Raj S
RS
Wallen
Eric M
EM
Crandell
Jaime
J
Blyler
Diane
D
D003142:Communication; D003657:Decision Making; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D011594:Psychometrics; D035501:Uncertainty