title: African American prostate cancer survivors' treatment decision-making and quality of life.
abstract: OBJECTIVE
  To examine African-American prostate cancer (PCa) survivors' involvement in treatment decision-making (TDM), and examine the association between TDM and quality of life (QOL), using secondary data.
  
  
  METHODS
  African-American PCa survivors (181) were recruited from the North Carolina Central Cancer Registry. Participants completed a cross-sectional survey that asked about their chosen cancer treatment, TDM factors, and PCa-specific QOL (using the Expanded Prostate Cancer Index Composite--EPIC). Multivariate analysis of covariance was conducted to determine the association between TDM and QOL, controlling for confounders.
  
  
  RESULTS
  Most men reported being active (44.2%) or collaborative (38.1%) in TDM, while 14.4% preferred a passive role. Adjusting for marital status, education and treatment, passive patients reported somewhat better QOL compared to active patients in the following QOL domains: urinary summary (p=0.04), urinary function (p=0.01), and urinary incontinence (p=0.03).
  
  
  CONCLUSIONS
  Most African-American PCa survivors preferred to be, and were, actively or collaboratively involved in TDM. However, those who preferred a passive role reported better PCa-specific QOL for the urinary domain compared to others.
  
  
  CONCLUSIONS
  It is important to assess patients' TDM preference. Patients' QOL may differ by their TDM role, such that active patients may be more bothered by treatment side effects than other patients.
authors.affiliation: Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. npalmer@wakehealth.edu
authors.forename: Nynikka R A
authors.initials: NR
authors.lastname: Palmer
authors.forename: Janet A
authors.initials: JA
authors.lastname: Tooze
authors.forename: Aubrey R
authors.initials: AR
authors.lastname: Turner
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Xu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Avis
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina; D010358:Patient Participation; D057240:Patient Preference; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012042:Registries; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data