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Decisional regret and quality of life after participating in medical decision‐making for early‐stage prostate cancer
Author(s) -
Davison B.J.,
Goldenberg S.L.
Publication year - 2003
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2003.04005.x
Subject(s) - regret , medicine , prostate cancer , quality of life (healthcare) , prostatectomy , distress , sexual function , stage (stratigraphy) , decision quality , gynecology , cancer , patient satisfaction , surgery , clinical psychology , nursing , paleontology , machine learning , computer science , biology
OBJECTIVE To determine the effect of men's reported levels of involvement in medical decision‐making and quality of life (QoL) on their levels of decisional regret after definitive treatment. PATIENTS AND METHODS Men referred to a hospital‐based resource centre completed QoL and decisional‐regret measures after definitive treatment for localized prostate cancer. Data from these questionnaires were linked with a previous study conducted to determine if providing individualized information to men newly diagnosed with prostate cancer would lower their levels of psychological distress and enable them to become more active participants in treatment decision‐making. The preferred role in medical decision‐making and QoL had previously been measured at the time of diagnosis and the assumed role at 4 months after the definitive treatment decision. This postal survey was conducted ≈ 18 months after diagnosis. RESULTS Of 74 men, 67 (91%) responded; the mean ( sd ) time since definitive treatment was 10.3 (4.7) months and the mean age of the men 62.5 (6.9) years. Radical prostatectomy was the most frequent treatment (72%). Most (94%) patients participated in medical decision‐making either actively or collaboratively and did not regret their treatment choice. The type of definitive treatment received had no effect on decisional regret; patients’ QoL scores were similar to the levels before treatment. Levels of sexual function were significantly lower after definitive treatment, but urinary incontinence was not significantly affected. Men who had neoadjuvant hormone therapy reported having significantly more treatment‐related symptoms. CONCLUSIONS There is no evidence that providing information to facilitate participation in medical decision‐making causes decisional regret or psychological distress within the first year after definitive treatment. A longitudinal follow‐up of these patients is required to adequately assess the long‐term effects of treatment on QoL and decisional regret.