Social ecological influences on treatment decision-making in men diagnosed with low risk, localised prostate cancer Journal Article


Authors: McIntosh, M.; Opozda, M. J.; Short, C. E.; Galvão, D. A.; Tutino, R.; Diefenbach, M.; Ehdaie, B.; Nelson, C.
Article Title: Social ecological influences on treatment decision-making in men diagnosed with low risk, localised prostate cancer
Abstract: Objective: Individuals diagnosed with low risk, localised prostate cancer (PCa) face a difficult decision between active surveillance (AS) and definitive treatment. We aimed to explore perceived influences on treatment decision-making from the patient and partner's perspectives. Methods: Patients (and partners) who met AS criteria and had chosen their treatment were recruited. Semi-structured individual interviews were conducted via telephone to explore experiences of diagnosis, impact on patient lifestyle, experiences with physicians, treatment preferences/choice, treatment information understanding and needs, and overall decision-making process. Interviews were audio recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis. Results: Twenty-four male patients (18 chose AS) and 12 female partners participated. Five themes relating to social-ecological influences on treatment choice were identified: (1) partner support and direct influence on patient treatment choice, (2) patient and partner vicarious experiences may influence treatment decisions, (3) the influence of the patient's life circumstances, (4) disclosing to wider social networks: friends, family, and co-workers, and (5) the importance of a good relationship and experience with physicians. Additionally, two themes were identified relating to information patients and partners received about the treatment options during their decision-making process. Conclusions: A range of individual and social influences on treatment decision-making were reported. Physicians providing treatment recommendations should consider and discuss the patient and partner's existing beliefs and treatment preferences and encourage shared decision-making. Further research on treatment decision-making of partnered and non-partnered PCa patients is required. We recommend research considers social ecological factors across the personal, interpersonal, community, and policy levels. © 2022 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.
Keywords: prostate cancer; active surveillance; qualitative research; supportive care; treatment decision-making; decision-making
Journal Title: European Journal of Cancer Care
Volume: 31
Issue: 6
ISSN: 0961-5423
Publisher: Wiley Blackwell  
Date Published: 2022-11-01
Start Page: e13697
Language: English
DOI: 10.1111/ecc.13697
PROVIDER: scopus
PUBMED: 36138320
PMCID: PMC9786728
DOI/URL:
Notes: Article -- Export Date: 1 December 2022 -- Source: Scopus
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  1. Behfar Ehdaie
    174 Ehdaie
  2. Christian Nelson
    392 Nelson
  3. Rebecca C Tutino
    19 Tutino