Literature DB >> 17394734

"It's a maybe test": men's experiences of prostate specific antigen testing in primary care.

Rhodri Evans1, Adrian G K Edwards, Glyn Elwyn, Eila Watson, Richard Grol, Jo Brett, Joan Austoker.   

Abstract

BACKGROUND: Prostate specific antigen (PSA) testing in primary care is an important and contentious issue. Due to concerns about the test and the value of early detection, countries such as the UK advocate 'informed choice' instead of population screening. It is not known whether this policy is actually adhered to in primary care. Furthermore, little is known of the experiences of men who face this decision. AIM: To explore the experiences, understanding, and views of men who considered or undertook PSA testing in UK primary care. DESIGN OF STUDY: Qualitative interview-based study.
SETTING: Primary care, Wales, UK.
METHOD: Semi-structured one-to-one interviews were conducted with 28 men, representing a range of clinical outcomes. Transcripts were coded and subjected to thematic analysis.
RESULTS: Three themes were identified: the decision-making context, the locus of decision making, and uncertainty related to the PSA test.
CONCLUSION: The decision to undertake PSA testing was affected by both social and media factors and it did not appear to be a patient-led decision. The decision created considerable uncertainty for men and this uncertainty persisted after the test, even if the result was normal. Raised PSA led to further investigations and this exacerbated the uncertainty. Anxiety and regret were consequences of this uncertainty.

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Year:  2007        PMID: 17394734      PMCID: PMC2043329     

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN: 0960-1643            Impact factor:   5.386


  10 in total

Review 1.  Qualitative research in health care. Assessing quality in qualitative research.

Authors:  N Mays; C Pope
Journal:  BMJ       Date:  2000-01-01

Review 2.  Explaining risks: turning numerical data into meaningful pictures.

Authors:  Adrian Edwards; Glyn Elwyn; Al Mulley
Journal:  BMJ       Date:  2002-04-06

3.  Screening without evidence of efficacy.

Authors:  Malcolm Law
Journal:  BMJ       Date:  2004-02-07

4.  Idealistic, impractical, impossible? Shared decision making in the real world.

Authors:  Glyn Elwyn
Journal:  Br J Gen Pract       Date:  2006-06       Impact factor: 5.386

5.  Lower urinary tract symptoms: social influence is more important than symptoms in seeking medical care.

Authors:  R Wolters; M Wensing; C van Weel; G J van der Wilt; R P T M Grol
Journal:  BJU Int       Date:  2002-11       Impact factor: 5.588

Review 6.  Management of cancer of the prostate.

Authors:  W J Catalona
Journal:  N Engl J Med       Date:  1994-10-13       Impact factor: 91.245

Review 7.  Diagnosis, management and screening of early localised prostate cancer.

Authors:  S Selley; J Donovan; A Faulkner; J Coast; D Gillatt
Journal:  Health Technol Assess       Date:  1997       Impact factor: 4.014

8.  Developing a quality criteria framework for patient decision aids: online international Delphi consensus process.

Authors:  Glyn Elwyn; Annette O'Connor; Dawn Stacey; Robert Volk; Adrian Edwards; Angela Coulter; Richard Thomson; Alexandra Barratt; Michael Barry; Steven Bernstein; Phyllis Butow; Aileen Clarke; Vikki Entwistle; Deb Feldman-Stewart; Margaret Holmes-Rovner; Hilary Llewellyn-Thomas; Nora Moumjid; Al Mulley; Cornelia Ruland; Karen Sepucha; Alan Sykes; Tim Whelan
Journal:  BMJ       Date:  2006-08-14

9.  Why men with prostate cancer want wider access to prostate specific antigen testing: qualitative study.

Authors:  Alison Chapple; Sue Ziebland; Sasha Shepperd; Rachel Miller; Andrew Herxheimer; Ann McPherson
Journal:  BMJ       Date:  2002-10-05

Review 10.  Quality improvement report: Improving design and conduct of randomised trials by embedding them in qualitative research: ProtecT (prostate testing for cancer and treatment) study. Commentary: presenting unbiased information to patients can be difficult.

Authors:  Jenny Donovan; Nicola Mills; Monica Smith; Lucy Brindle; Ann Jacoby; Tim Peters; Stephen Frankel; David Neal; Freddie Hamdy
Journal:  BMJ       Date:  2002-10-05
  10 in total
  18 in total

1.  Factors influencing Nigerian men's decision to undergo prostate specific antigen testing.

Authors:  Oghenetejiri Ubrurhe Enaworu; Ranjit Khutan
Journal:  Afr Health Sci       Date:  2016-06       Impact factor: 0.927

Review 2.  PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making.

Authors:  Lionne D F Venderbos; Monique J Roobol
Journal:  Asian J Androl       Date:  2011-02-07       Impact factor: 3.285

3.  What Do Men Want from a Health Screening Mobile App? A Qualitative Study.

Authors:  Chin Hai Teo; Chirk Jenn Ng; Alan White
Journal:  PLoS One       Date:  2017-01-06       Impact factor: 3.240

Review 4.  Men's perspectives of prostate cancer screening: A systematic review of qualitative studies.

Authors:  Laura J James; Germaine Wong; Jonathan C Craig; Camilla S Hanson; Angela Ju; Kirsten Howard; Tim Usherwood; Howard Lau; Allison Tong
Journal:  PLoS One       Date:  2017-11-28       Impact factor: 3.240

5.  Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners.

Authors:  Frances J Drummond; Anne-Elie Carsin; Linda Sharp; Harry Comber
Journal:  BMC Fam Pract       Date:  2009-01-12       Impact factor: 2.497

6.  Dual equipoise shared decision making: definitions for decision and behaviour support interventions.

Authors:  Glyn Elwyn; Dominick Frosch; Stephen Rollnick
Journal:  Implement Sci       Date:  2009-11-18       Impact factor: 7.327

7.  Biomarkers, the molecular gaze and the transformation of cancer survivorship.

Authors:  Kirsten Bell
Journal:  Biosocieties       Date:  2013-06

8.  A randomised controlled trial of the effects of a web-based PSA decision aid, Prosdex. Protocol.

Authors:  Rhodri Evans; Glyn Elwyn; Adrian Edwards; Robert Newcombe; Paul Kinnersley; Pat Wright; Jeff Griffiths; Joan Austoker; Richard Grol
Journal:  BMC Fam Pract       Date:  2007-10-04       Impact factor: 2.497

9.  Toward a model for field-testing patient decision-support technologies: a qualitative field-testing study.

Authors:  Rhodri Evans; Glyn Elwyn; Adrian Edwards; Eila Watson; Joan Austoker; Richard Grol
Journal:  J Med Internet Res       Date:  2007-07-13       Impact factor: 5.428

10.  Urological referral of asymptomatic men in general practice in England.

Authors:  J Melia; P Coulson; D Coleman; S Moss
Journal:  Br J Cancer       Date:  2008-03-18       Impact factor: 7.640

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