PREFERENCE FOR DECISION MAKING ROLE IN PROSTATE CANCER SURVIVORS IS ASSOCIATED WITH ILLNESS PERCEPTIONS AND SATISFACTION WITH INFORMATION PROVISION: RESULTS FROM THE PROFILES-REGISTRY

Purpose:

Patient involvement in medical encounters can range from minimum patient involvement to minimum clinician involvement. For treating prostate cancer (Pca) multiple treatment options are available. Although oncologically equivalent, each option has a specific risk and side-effect profile, making treatment selection values and preference sensitive. This context is optimally suited for an active or collaborative patient role in the treatment decision making process. However, not all patients prefer this role. In a sample of Pca-survivors we investigated decision making role preferences in relation to illness perceptions, satisfaction with information provision and treatment choice. 

Method:

A random selection of men (N=792) diagnosed between 2006 and 2009 with a T1 or T2-stage Pca and registered in the Eindhoven Cancer Registry (ECR), received a questionnaire measuring preferred decision making role (CPS), satisfaction with information provision (EORTC QLQ-INFO25) and illness perception (B-IPQ). Response rate was 71% (N=562). Questionnaires were filled in with a median of 48 months since diagnosis. Analysis was performed using ANOVA and chi-square tests.

Result:

Approximately 60% of the Pca survivors prefers a collaborative decision making role, active and passive roles are each represented by 20% of the sample.  As expected, men who prefer an active role are more often younger and better educated then their passive counterparts (both with P<.001). Also, each role preference is characterized by a significantly different treatment profile. Active decision makers are more likely to have undergone surgery, while radiation therapy is performed more among men with a preference for a passive role (P<.01). Men with a preference for a passive role also report worse illness perceptions and are less satisfied with information provision, specifically in the T1-stage tumor group (both with P<0.05).

Conclusion:

Although the clinical management of T1 and T2-stage tumors is identical, we find differences in illness perceptions, satisfaction with information provision and treatment choice based on decision making role preferences. Specifically men with a low-risk (T1) tumor and a passive role preference report worse outcomes. As role preference was measured post-treatment we believe it can represent an underlying attitude that could be assumed a trait. This further highlights the need for screening on the preferred role prior to decision making and a tailored approach in information provision and decisional support.