Decision Making For Active Surveillance in Prostate Cancer Patients and Spouses

前列腺癌患者和配偶主动监测的决策

• 批准号: 8534064
• 负责人: Michael A Diefenbach
• 金额: $ 18.06万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8534064
• 关键词: Address; Adverse effects; Advocate; Affective; Aftercare; Ally; Anxiety; Belief; Cancer Patient; Cognitive; Data; Data Collection; Decision Making; Diagnosis; Disease; Early treatment; Erectile dysfunction; Future; Goals; Individual; Informal Social Control; Intervention; Interview; Lead; Literature; Malignant Neoplasms; Malignant neoplasm of prostate; Memorial Sloan-Kettering Cancer Center; Methods; Participant; Patients; Persons; Physicians; Play; Process; Prostate-Specific Antigen; Psychological Factors; Questionnaires; Recruitment Activity; Regimen; Reporting; Research; Role; Screening for cancer; Services; Social support; Spouses; Staging; United States; Urinary Incontinence; Urology; active method; cancer site; clinical practice; cognitive function; insight; irritation; medical schools; men; preference; screening; social; theories

DESCRIPTION (provided by applicant): Prostate cancer is the most common site of cancer in men in the United States with over 240,000 men diagnosed with prostate cancer in 2011. Over the past years, widespread prostate specific antigen (PSA) screening has resulted in the earlier detection of these cancers. Screening has also led to controversy as men with very early stage disease are being treated when it is not clear to what extent treatment may be of benefit to them. Many clinicians agree that early stage disease is being over treated and it is estimated that 27-56% of men who undergo treatment for early stage prostate cancer can be managed effectively with active surveillance (AS). Given the potential for significant side-effects (e.g., erectile dysfunction, urinary incontinence, and bowl irritation) associated with treatment, AS is an important and viable alternative for patients with low-grade disease. Physicians have noticed that psychological factors such as anxiety or certain disease and treatment related beliefs may be influencing men and their partners to select active treatment (AT) over AS. In addition, intimate partners often exert an important influence of treatment choice as they are the primary social support for cancer patients. These anecdotal observations are supported by theory (i.e., self- regulation theory) and reports in the literature. However, a systematic examination of the influence of these cognitive-affective and social factors on the decision to decide on and adhere to an AS regimen is missing. The present application aims to investigate the decision making process for AS using a theory-guided self- regulation approach focusing on cognitive, affective and social/partner factors. This will be the first comprehensive examination of the contribution of affective and cognitive processes to decision making for AS. It will also be the first in this literature to include the perspective of patients' partners on decision making through the use of qualitative and quantitative data collection methods. Thus, the specific aims are: 1) to explore the cognitive and affective treatment decision-making processes among prostate cancer patients who are eligible for active surveillance and their partners/close allies. Aim 2: To explor how patients arrived at their decision and to investigate the influence partners/close allies play in this process.

描述（由申请人提供）：前列腺癌是美国男性中最常见的癌症部位，2011年有超过240，000名男性被诊断患有前列腺癌。在过去的几年里，广泛的前列腺特异性抗原（PSA）筛查导致这些癌症的早期检测。筛查也引起了争议，因为患有非常早期疾病的男性正在接受治疗，而不清楚治疗在多大程度上对他们有益。许多临床医生认为，早期疾病正在被过度治疗，据估计，27-56%接受早期前列腺癌治疗的男性可以通过主动监测（AS）进行有效管理。考虑到潜在的严重副作用（例如，勃起功能障碍、尿失禁和排便刺激），AS是低度疾病患者的重要和可行的替代方案。医生们已经注意到，心理因素，如焦虑或某些疾病和治疗相关的信念可能会影响男性及其伴侣选择积极治疗（AT）而不是AS。此外，亲密伴侣通常对治疗选择产生重要影响，因为他们是癌症患者的主要社会支持。这些轶事观察得到了理论的支持（即，自我调节理论）和文献中的报道。然而，这些认知情感和社会因素的影响，决定决定并坚持AS方案的系统检查是失踪。本申请旨在使用理论指导的自我调节方法研究AS的决策过程，该方法关注认知、情感和社会/伙伴因素。这将是第一次全面审查 情感和认知过程对AS决策的影响。它也将是该文献中第一个通过使用定性和定量数据收集方法纳入患者伴侣对决策的观点的文献。因此，具体目标是：1）探索符合主动监测条件的前列腺癌患者及其伴侣/亲密盟友的认知和情感治疗决策过程。目的2：探索患者如何做出决定，并调查合作伙伴/亲密盟友在这一过程中的影响。

项目成果

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

• DOI: 10.1111/ecc.13697
• 发表时间: 2022-11
• 期刊: EUROPEAN JOURNAL OF CANCER CARE
• 影响因子: 2.1
• 作者: McIntosh, Megan;Opozda, Melissa J.;Short, Camille E.;Galvao, Daniel A.;Tutino, Rebecca;Diefenbach, Michael;Ehdaie, Behfar;Nelson, Christian
• 通讯作者: Nelson, Christian