Decision-Making Under Uncertainty in Prostate Cancer

前列腺癌不确定性下的决策

• 批准号: 6926077
• 负责人: MERLE H MISHEL
• 金额: $ 33.2万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6926077
• 关键词: African American; Internet; behavioral /social science research tag; caucasian American; clinical research; communication behavior; decision making; health education; human subject; interview; neoplasm /cancer diagnosis; neoplasm /cancer therapy; nursing intervention; outcomes research; patient care planning; physicians; prostate neoplasms; quality of life; racial /ethnic difference; social support network; telemedicine

DESCRIPTION: (provided by applicant) The proposed study tests the efficacy of a decision-making intervention to help men newly diagnosed with prostate cancer become informed participants in the decision-making process with the physician. Since there is no preferred treatment for prostate cancer, the situation is one of therapeutic uncertainty from the perspective of the physician and one of informational uncertainty experienced by newly diagnosed cancer patients. Two approaches for the delivery of the intervention will be tested: intervention delivered to the patient only (treatment direct) or intervention to the patient and his primary support person (treatment supplemented). The intervention will focus on providing the patient with information about treatment options via a nurse-delivered telephone protocol. The information will be supplemented with decision aids including a study-designed portal to selected Internet sites on decision-making in prostate cancer. The intervention will also focus on communication skills training to enhance patient communicator behaviors. The decision-making intervention will be tested with Caucasian and African-American men within the 2-3 week period between receiving a cancer diagnosis and meeting with the physician to discuss treatment options. The design is a 2 X 3 randomized block, repeated measures design with 3 levels of intervention (treatment direct, treatment supplemented, and control condition) crossed with 2 levels of ethnicity. Measures will be taken at baseline and at 4 weeks and 4 months post baseline. Men who receive the decision-making intervention are expected to have less decisional regret, less decisional uncertainty, more treatment knowledge, better patient-provider communication, more perceived effective decision-making, more active communication behaviors, and better reported quality of life than the control group. Multivariate models will be used for analysis. Costs of delivering the intervention will be estimated for dissemination of intervention protocol.

描述：（由申请人提供）拟议的研究测试了决策干预措施的功效，以帮助新诊断为前列腺癌的男性与医生在决策过程中成为知情的参与者。 由于没有对前列腺癌的首选治疗方法，因此从医生的角度来看，这种情况是治疗性不确定性之一，也是新诊断的癌症患者经历的信息不确定性之一。 将测试提供两种干预措施的方法：仅将干预措施（直接治疗）或干预措施交付给患者及其主要支持人员（补充治疗）。 干预措施将着重于通过保存护士的电话协议为患者提供有关治疗方案的信息。 该信息将补充决策辅助工具，包括针对前列腺癌决策的精选互联网站点的研究门户。 干预还将集中于沟通技巧培训，以增强患者的沟通行为。 决策干预措施将在接受癌症诊断和与医生会面以讨论治疗方案之间的2-3周内与高加索和非裔美国人的男性进行测试。该设计是一个2 x 3的随机块，重复测量设计，具有3级干预（治疗，治疗补充和对照条件），并具有2个种族水平。 基线后4周零4个月将采取措施。 接受决策干预的男性预计将较少的决策遗憾，决策不确定性，更多的治疗知识，更好的患者沟通，更有效的有效决策，更多的积极沟通行为以及比对照组更好的生活质量。 多元模型将用于分析。 提供干预的成本将估计用于传播干预方案。