MP15-03 PREDICTORS OF DECISIONAL CONFLICT IN MEN WITH NEWLY DIAGNOSED PROSTATE CANCER: BASELINE RESULTS FROM A SHARED DECISION-MAKING TRIAL

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2014MP15-03 PREDICTORS OF DECISIONAL CONFLICT IN MEN WITH NEWLY DIAGNOSED PROSTATE CANCER: BASELINE RESULTS FROM A SHARED DECISION-MAKING TRIAL Alan L. Kaplan, MD Catherine M. Crespi, Ph.D. Josemanuel Saucedo, MPH Ely Dahan, Ph.D, MBA Sylvia Lambrechts, MPH, MA Robert Kaplan, andPh.D. Christopher SaigalMD, MPH Alan L. KaplanAlan L. Kaplan More articles by this author , Catherine M. CrespiCatherine M. Crespi More articles by this author , Josemanuel SaucedoJosemanuel Saucedo More articles by this author , Ely DahanEly Dahan More articles by this author , Sylvia LambrechtsSylvia Lambrechts More articles by this author , Robert KaplanRobert Kaplan More articles by this author , and Christopher SaigalChristopher Saigal More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.556AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men diagnosed prostate cancer face a major decision that may significantly impact their quality of life. “Decisional conflict” is a measure of the uncertainty surrounding a treatment choice and a patient’s confidence in making this choice. Decisional conflict is a source of anxiety and stress and is a key factor in decision quality, but little data exists to help the urologist identify which patients are at risk. To identify predictors of baseline decisional conflict, we conducted a cross-sectional study of men with newly diagnosed localized prostate cancer before any treatment choices were made. METHODS We surveyed 68 men at a Veterans Administration clinic with newly diagnosed localized prostate cancer enrolled in an ongoing randomized trial evaluating decision quality associated with a novel shared decision making approach involving preference assessment. Demographic, clinical, and functional data were collected at baseline. Candidate predictors included age, race, education, comorbidity, relationship status, baseline urinary or sexual dysfunction, and prostate cancer knowledge. Tested outcome variables were total Decisional Conflict Scale (DCS) score, Uncertainty Subscale, and Perceived Effectiveness Subscale. We used multiple linear regression modeling to identify predictors of decisional conflict. RESULTS Mean age was 63 years, 49% were of African American race, and 70% reported an income less than $30,000. Older age was associated with lower perceived effectiveness of decision making (p=0.005). Poor prostate cancer knowledge was associated with increased overall decisional conflict and higher uncertainty (p<0.001 and p=0.001, respectively). Poor knowledge also predicted lower perceived effectiveness (p=0.003). Being in a relationship was associated with less decisional conflict (p=0.03). CONCLUSIONS We find that decreased knowledge about prostate cancer is associated with increased decisional conflict and lower perceived effective decision making. Interventions aimed at increasing comprehension of prostate cancer and its treatments may reduce decisional conflict and raise decisional quality. Additionally, increasing age is a risk factor for lowered perceived effective decision making. Further work is required to better characterize this relationship and identify potential mitigators. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e144-e145 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Alan L. Kaplan More articles by this author Catherine M. Crespi More articles by this author Josemanuel Saucedo More articles by this author Ely Dahan More articles by this author Sylvia Lambrechts More articles by this author Robert Kaplan More articles by this author Christopher Saigal More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...