Understanding Advanced Prostate Cancer Decision Making Utilizing an Interactive Decision Aid.
BACKGROUND
Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer deaths among men in the United States. Patients with advanced prostate cancer are vulnerable to difficult treatment decisions because of the nature of their disease.


OBJECTIVE
The aims of this study were to describe and understand the lived experience of patients with advanced prostate cancer and their decision partners who utilized an interactive decision aid, DecisionKEYS, to make informed, shared treatment decisions.


METHODS
This qualitative study uses a phenomenological approach that included a sample of 35 pairs of patients and their decision partners (16 pairs reflected patients with <6 months since their diagnosis of metastatic castration-resistant prostate cancer; 19 pairs reflected patients with >6 months since their diagnosis of metastatic castration-resistant prostate cancer). Qualitative analysis of semistructured interviews was conducted describing the lived experience of patients with advanced prostate cancer and their decision partners using an interactive decision aid.


RESULTS
Three major themes emerged: (1) the decision aid facilitated understanding of treatment options; (2) quality of life was more important than quantity of life; and (3) contact with healthcare providers greatly influenced decisions.


CONCLUSIONS
Participants believed the decision aid helped them become more aware of their personal values, assisted in their treatment decision making, and facilitated an interactive patient-healthcare provider relationship.


CONCLUSIONS
Decision aids assist patients, decision partners, and healthcare providers make satisfying treatment decisions that affect quality/quantity of life. These findings are important for understanding the experiences of patients who have to make difficult decisions.
Author Affiliations: School of Nursing (Drs Jones and Hollen and Ms Sims) and School of Medicine (Dr Weiss), University of Virginia, Charlottesville; School of Nursing (Dr Wenzel) and School of Medicine (Dr Daniel Song), Johns Hopkins University, Baltimore, Maryland; and Public Health Sciences, University of Virginia, Charlottesville (Dr Petroni).
Randy A
RA
Jones
Patricia J
PJ
Hollen
Jennifer
J
Wenzel
Geoff
G
Weiss
Daniel
D
Song
Terran
T
Sims
Gina
G
Petroni
D000368:Aged; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D036301:Qualitative Research; D011788:Quality of Life; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data