Managing uncertainty about treatment decision making in early stage prostate cancer: A randomized clinical trial

• Published in: Patient education and counseling 2009-12, Vol.77 (3), p.349-359
• Main Authors: Mishel, Merle H, Germino, Barbara B, Lin, Lin, Pruthi, Raj S, Wallen, Eric M, Crandell, Jaime, Blyler, Diane
• Format: Article
• Language: English
• Subjects: Black American people; Communication; Decision Making; Decision making, Uncertainty theory; Humans; Internal Medicine; Linear Models; Male; Men; Middle Aged; Models, Psychological; Nursing; Patient Satisfaction; Physician-Patient Relations; Problem solving; Prostate cancer; Prostatic cancer; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - radiotherapy; Prostatic Neoplasms - surgery; Psychometrics; Treatment; Uncertainty
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2009.09.009

Abstract Objective The purpose of this study was to examine the effects of a theory-based decision-making uncertainty management intervention (DMUMI) providing newly diagnosed prostate cancer patients with information, communication skills and personally designed prompts. Methods A randomized clinical trial was conducted using a 3 × 2 design with intervention and control groups including both Caucasian and African-American men. General linear mixed models were used to compare intervention groups over time. Results Significant main effects for the treatment groups were found for uncertainty management (cancer knowledge, problem-solving, and patient–provider communication), medical communication competence, number and helpfulness of resources for information, and decisional regret. Conclusion The intervention was effective in uncertainty management for Caucasian and African-American men, specifically in preparing competent patients with improved knowledge, problem-solving skills, information resources, and communication skills. Using the Uncertainty in Illness Theory, specific skills were selected with a focus on the antecedents of uncertainty. Practice implications In the treatment decision-making context, patients and supportive others need information about disease, treatment options and side effects but they also need communication skills training prior to the treatment decision consultation.