Acceptability and Preliminary Feasibility of an Internet/CD-ROM-Based Education and Decision Program for Early-Stage Prostate Cancer Patients: Randomized Pilot Study
Acceptability and Preliminary Feasibility of an Internet/CD-ROM-Based Education and Decision Program for Early-Stage Prostate Cancer Patients: Randomized Pilot Study
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DOI：
10.2196/jmir.1891
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发表时间：
2012-01-01
影响因子：
7.4
通讯作者：
Hall, Simon J.
中科院分区：
文献类型：
--
作者：
Diefenbach, Michael A.;Mohamed, Nihal E.;Hall, Simon J.
背景：前列腺癌是美国男性最常见的癌症。局部疾病的管理方案是存在的，但仍然需要出现以证据为基础的治疗标准。虽然5年生存率接近98%，但所有治疗方案都有可能产生严重的副作用，如勃起功能障碍和尿失禁。因此，建议患者积极参与治疗决策过程。我们开发了一个基于互联网/CD-ROM的多媒体前列腺互动教育系统（PIES），以提高患者的治疗决策。PIES实际上反映了一个健康中心，通过直观的界面，使用视频，动画，图形和文本为患者提供有关前列腺癌及其治疗的信息。目标：（1）检查PIES干预的可接受性和可行性，并报告该计划在新诊断前列腺癌患者中进行的试点试验的初步结果，和（2）探讨定制PIES治疗信息的潜在影响，以参与者的信息寻求stylesonstudyoutcome.Methods：参与者（n = 72）是新诊断的局限性前列腺癌谁没有作出治疗决定的患者。患者被随机分配到3个实验条件：（1）对照条件（通过标准的国家癌症研究所小册子提供信息; 26%），和PIES（2）与剪裁（43%）和（3）没有定制患者的信息寻求风格（31%）。在干预前（t1）和干预后立即（t2）给药。测量包括评估和可接受的PIES干预，监测/钝化信息寻求风格，心理困扰，和决策相关的变量（例如，决策的信心，了解前列腺癌和治疗的感觉，和治疗偏好）。约79%的合格患者（72/91）完成了PIES干预前后的评估。与对照组相比，PIES组的患者更有可能报告其治疗选择的更高水平的信心，他们在做出治疗决定时收到的信息的更高水平的帮助，以及他们收到的信息在情感上令人放心。与对照组相比，PIES组患者需要更多关于治疗选择的信息的可能性显著降低，对治疗选择的焦虑程度降低，并且认为他们收到的信息是明确的（P <0.05）。定制PIES信息的信息寻求风格是不相关的决策variable.Conclusions：这项试点研究证实，PIES的实施在临床实践中是可行的，可以接受的前列腺癌的患者与最近的诊断。PIES改善了关键的决策过程变量，并减少了困难的医疗决策的情绪影响。
Background: Prostate cancer is the most common cancer affecting men in the United States. Management options for localized disease exist, yet an evidence-based criterion standard for treatment still has to emerge. Although 5-year survival rates approach 98%, all treatment options carry the possibility for significant side effects, such as erectile dysfunction and urinary incontinence. It is therefore recommended that patients be actively involved in the treatment decision process. We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System (PIES) to enhance patients' treatment decision making. PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface, using videos, animations, graphics, and texts.Objectives: (1) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis, and (2) to explore the potential impact of tailoring PIES treatment information to participants' information-seeking styles on study outcomes.Methods: Participants (n = 72) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision. Patients were randomly assigned to 3 experimental conditions: (1) control condition (providing information through standard National Cancer Institute brochures; 26%), and PIES (2) with tailoring (43%) and (3) without tailoring to a patient's information-seeking style (31%). Questionnaires were administrated before (t1) and immediately after the intervention (t2). Measurements include evaluation and acceptability of the PIES intervention, monitoring/blunting information-seeking style, psychological distress, and decision-related variables (eg, decisional confidence, feeling informed about prostate cancer and treatment, and treatment preference).Results: The PIES program was well accepted by patients and did not interfere with the clinical routine. About 79% of eligible patients (72/91) completed the pre- and post-PIES intervention assessments. Patients in the PIES groups compared with those in the control condition were significantly more likely to report higher levels of confidence in their treatment choices, higher levels of helpfulness of the information they received in making a treatment decision, and that the information they received was emotionally reassuring. Patients in the PIES groups compared with those in the control condition were significantly less likely to need more information about treatment options, were less anxious about their treatment choices, and thought the information they received was clear (P < .05). Tailoring PIES information to information-seeking style was not related to decision-making variables.Conclusions: This pilot study confirms that the implementation of PIES within a clinical practice is feasible and acceptable to patients with a recent diagnosis of prostate cancer. PIES improved key decision-making process variables and reduced the emotional impact of a difficult medical decision.