1002 EXAMINING AN INTERACTIVE, MULTIMEDIA EDUCATION AND DECISION PROGRAM FOR EARLY-STAGE PROSTATE CANCER PATIENTS

Abstract

INTRODUCTION AND OBJECTIVES: Treatment options for localized prostate cancer (CaP) are characterized by excellent 5-yr survival prospects, but varying implications for quality of life. Thus, there is a need for extensive patient education for treatment decision making. We developed an Internet-based multimedia CaP educational software (PIES) that provides patients with information about CaP and its treatment through an intuitive interface, using video, animation, and text. We used the metaphor of a virtual health center to present the information. The current study evaluates the efficacy of PIES in facilitating decision making. We hypothesize that PIES will reduce decisional conflict and increase confidence in the treatment decision compared to standard care. METHODS: Patients diagnosed with localized CaP who had not made a treatment decision were randomized into 3 groups: a) Standard care receiving NCI print materials (n 24); b) PIES with information tailored to information seeking preference (n 39); c) PIES without tailored information (n 27). We administrated questionnaires before the intervention (t1), following the intervention (t2), and six weeks later (t3). Measurements include the Decisional Conflict Scale (i.e., uncertainty in choosing options, informed decision, value clarification, decisional support, O’Connor, 1995) and measures to assess confidence in the decision and emotional impact of the information (Diefenbach et al., 2002). RESULTS: Patients were on average 60 years (SD 1.18), white and married. There were no differences in outcome variables between the tailored and non-tailored PIES groups, thus they were combined (n 66). At t2 the combined PIES group, compared to standard care, reported a significant increase in confidence to make a treatment decision, indicated that their decision was more congruent with their values, and experienced the information as more reassuring and less distressing (all ps .05). Comparisons between baseline and the six weeks follow-up assessment showed that these effects persisted as patients in the PIES group continued to be better informed about their options, displayed reduced decisional uncertainty, and were better informed about the benefits that mattered most to them, compared to the standard care group. CONCLUSIONS: Using PIES prior to making a treatment decision leads to reduced decisional conflict, increased confidence, and a value concordant decision.