Provider and partner interactions in the treatment decision-making process for newly diagnosed localized prostate cancer.
OBJECTIVE
• To evaluate the degree to which the partners of prostate cancer patients participate in the shared decision-making process with the patients' providers during the time between diagnosis and initiating treatment.


METHODS
• We recruited patients with newly diagnosed local-stage prostate cancer and their partners to complete take-home surveys after biopsy but before initiating treatment at urology practices in three states. • We asked partners to describe their roles in the decision-making process, including participation in clinic visits, and perceptions of encouragement from providers to participate in the treatment decision-making process. We also asked partners to rate their satisfaction with the patients' providers.


RESULTS
• Family members of 80% of newly diagnosed patients agreed to participate; most (93%) were partners (i.e. spouses or significant others). Most partners (93%) had direct contact with the patients' physicians. • Among the partners who had contact with providers, most (67%) were very satisfied with the patients' providers and 80% indicated that the doctor encouraged them to participate in the treatment decision. Overall, 91% of partners reported very frequent discussions with their loved one about the pending treatment decision, and 69% reported that their role was to help the patient make a decision. • In multivariate models, provider encouragement of partner participation was associated with higher partner satisfaction (odds ratio 3.4, 95% CI 1.4-8.4) and an increased likelihood of partners reporting very frequent discussions with their loved one (odds ratio 6.1, 95% CI 1.3-27.7).


CONCLUSIONS
• Partners often attended clinic visits and were very involved in discussions about treatment options with both loved ones and providers. • Provider encouragement of participation by partners greatly facilitates shared decision-making between patients and partners.
Department of Veterans Affairs Medical Center, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Steven B
SB
Zeliadt
David F
DF
Penson
Carol M
CM
Moinpour
David K
DK
Blough
Catherine R
CR
Fedorenko
Ingrid J
IJ
Hall
Judith Lee
JL
Smith
Donatus U
DU
Ekwueme
Ian M
IM
Thompson
Thomas E
TE
Keane
Scott D
SD
Ramsey
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011368:Professional-Family Relations; D011471:Prostatic Neoplasms / Q000523:psychology*; D012944:Social Support; D018454:Spouses / Q000523:psychology*