Literature DB >> 22570252

Testing the feasibility, acceptability and effectiveness of a 'decision navigation' intervention for early stage prostate cancer patients in Scotland--a randomised controlled trial.

Belinda Hacking1, Louise Wallace, Sarah Scott, Joanna Kosmala-Anderson, Jeffrey Belkora, Alan McNeill.   

Abstract

OBJECTIVE: Does decision navigation (DN) increase prostate cancer patients' confidence and certainty in treatment decisions, while reducing regret associated with the decisions made?
METHODS: Two hundred eighty-nine newly diagnosed prostate cancer patients were eligible. 123 consented and were randomised to usual care (n = 60) or navigation (n = 63). The intervention involved a 'navigator' guiding the patient in creating a personal question list for a consultation and providing a CD and typed summary of the consultation to patients, the general practitioner and physician. The primary outcome was decisional self efficacy. Secondary outcomes included decisional conflict (DCS) and decisional regret (RS). Measures of mood (Hospital Anxiety and Depression Scale) and adjustment (Mental Adjustment to Cancer Scale) were included to detect potential adverse effects of the intervention.
RESULTS: ANOVA showed a main effect for the group (F = 7.161, df 1, p = 0.009). Post hoc comparisons showed significantly higher decisional self efficacy in the navigated patients post-consultation and 6 months later. Decisional conflict was lower for navigated patients initially (t = 2.005, df = 105, p = 0.047), not at follow-up (t = 1.969, df = 109, p = 0.052). Regret scores were significantly lower in the navigation group compared to the controls 6 months later (t = -2.130, df = 100, p = 0.036). There was no impact of the intervention on mood or adjustment.
CONCLUSION: Compared to control patients, navigated patients were more confident in making decisions about cancer treatment, were more certain they had made the right decision after the consultation and had less regret about their decision 6 months later. Decision navigation was feasible, acceptable and effective for newly diagnosed prostate cancer patients in Scotland.
Copyright © 2012 John Wiley & Sons, Ltd.

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Year:  2012        PMID: 22570252     DOI: 10.1002/pon.3093

Source DB:  PubMed          Journal:  Psychooncology        ISSN: 1057-9249            Impact factor:   3.894


  30 in total

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5.  Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study.

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6.  Decisional conflict in economically disadvantaged men with newly diagnosed prostate cancer: baseline results from a shared decision-making trial.

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7.  Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer.

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8.  Assessment of a brain-tumour-specific Patient Concerns Inventory in the neuro-oncology clinic.

Authors:  Alasdair G Rooney; Anouk Netten; Shanne McNamara; Sara Erridge; Sharon Peoples; Ian Whittle; Belinda Hacking; Robin Grant
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Review 9.  Shared decision-making and comparative effectiveness research for patients with chronic conditions: an urgent synergy for better health.

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10.  Patient preference and the impact of decision-making aids on prostate cancer treatment choices and post-intervention regret.

Authors:  J J Aning; R J Wassersug; S L Goldenberg
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