Abstract
AimTo explore the views of Malaysian healthcare professionals (HCPs) on stakeholders’ decision making roles in localized prostate cancer (PCa) treatment.MethodsQualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.FindingsThe participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients’ decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient’s treatment due to Malaysia’s close-knit family culture.ConclusionsA range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.
Highlights
Decision making about early prostate cancer is a complex, preference-sensitive choice involving many different options [1, 2]
A range of decision making roles were reported by healthcare professionals (HCPs)
It is important that stakeholder roles are clarified during prostate cancer (PCa) treatment decisions
Summary
Decision making about early prostate cancer is a complex, preference-sensitive choice involving many different options [1, 2]. Almost fifty percent of patients with prostate cancer find the decision difficult and distressing [3]. Most patients prefer to actively collaborate with their healthcare providers to make a decision [4]. A discrepancy often exists between patients’ actual and preferred decision making roles in cancer treatment [5, 6]. Patients with prostate cancer wish to involve their families and partners in the decision. All patients with prostate cancer preferred a collaborative decision role with their partners [7]. Support helps patients with informationgathering, active decision-making and clarifying a patient’s quality-of-life preferences [8]. Roles are especially relevant in the Malaysian context where family members have been reported to play active roles in various medication and surgical choices [9,10,11]
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