Abstract
The principal aim of the study was to investigate the role of individual characteristics in decisional conflict of patients with prostate cancer (PCa) in order to identify risk and protective features. An observational study was conducted with 83 PCa patients accessing the multidisciplinary visit of Prostate Cancer Program at Fondazione IRCCS Istituto Nazionale dei Tumori in Milan. The multidisciplinary visit (MDV) consists in two separate but interrelated parts: the medical consultation and the psychological consultation, which includes decision-making counseling. Patients’ decisional conflict was measured before entering the visit and two weeks after. Results underlined that decisional conflict decreased in the follow-up. Furthermore, perceived self-efficacy partially predicts a decrease in decisional conflict thus representing a protective factor while buck-passing defensive decisional style partially predicts an increase in decisional conflict thus representing a risk factor. To conclude, future interventions aiming to cope with PCa treatment decisional conflict might incorporate activities designed to boost decision-making self-efficacy.
Similar content being viewed by others
References
Aizer, A. A., Paly, J. J., & Efstathiou, J. A. (2013). Multidisciplinary care and management selection in prostate cancer. Seminars in Radiation Oncology, 23(3), 157–164. https://doi.org/10.1016/j.semradonc.2013.01.001.
Arora, N. K., Ayanian, J. Z., & Guadagnoli, E. (2005). Examining the relationship of patients’ attitudes and beliefs with their self-reported level of participation in medical decision-making. Medical Care, 43(9), 865–872.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.
Bandura, A. (1989). Human agency in social cognitive theory. American Psychologist, 44(9), 1175–1184. https://doi.org/10.1037/0003-066X.44.9.1175.
Bandura, A. (1997). Self-efficacy: The exercise of self-control. New York: Freeman.
Bansal, A., Koepl, L. M., Fedorenko, C. R., Li, C., Smith, J. L., Hall, I. J., Penson, D.F. & Ramsey, S. D. (2017). Information seeking and satisfaction with information sources among spouses of men with newly diagnosed local-stage prostate cancer. Journal of Cancer Education, 1-7. https://doi.org/10.1007/s13187-017-1179-6.
Barry, M. J. (1999). Involving patients in medical decisions. JAMA, 282(24), 2356–2357. https://doi.org/10.1001/jama.282.24.2356.
Bellardita, L., Rancati, T., Alvisi, M. F., Villani, D., Magnani, T., Marenghi, C., Nicolai, N., Procopio, G., Villa, S., Salvioni, R., & Valdagni, R. (2013). Predictors of health-related quality of life and adjustment to prostate cancer during active surveillance. European Urology, 64(1), 30–36. https://doi.org/10.1016/j.eururo.2013.01.009.
Bellardita, L., Valdagni, R., van den Bergh, R., Randsdorp, H., Repetto, C., Venderbos, L. D. F., Lane, J. A., & Korfage, I. J. (2015). How does active surveillance for prostate cancer affect quality of life? A systematic review. European Urology, 67(4), 637–645. https://doi.org/10.1016/j.eururo.2014.10.028.
Birnie, K., & Robinson, J. (2010). Helping patients with localized prostate cancer reach treatment decisions. Canadian Family Physician - Médecin de Famille Canadien, 56(2), 137–141.
Capocaccia, R., Foschi, R., Zucchetto, A., Valdagni, R., Nicolai, N., Maffezzini, M., & Gatta, G. (2016). Estimates of prostate cancer burden in Italy. Cancer Epidemiology, 40, 166–172. https://doi.org/10.1016/j.canep.2015.12.004.
Carter, H. B., Albertsen, P. C., Barry, M. J., Etzioni, R., Freedland, S. J., Greene, K. L., Holmberg, L., Kantoff, P., Konety, B. R., Murad, M. H., Penson, D. F., & Zietman, A. L. (2013). Early detection of prostate cancer: AUA guideline. The Journal of Urology, 190(2), 419–426. https://doi.org/10.1016/j.juro.2013.04.119.
Cervone, D. (2004). The architecture of personality. Psychological Review, 111(1), 183–204. https://doi.org/10.1037/0033-295X.111.1.183.
Cervone, D., Caldwell, T. L., Fiori, M., Orom, H., Shadel, W. G., Kassel, J. D., & Artistico, D. (2008). What underlies appraisals? Experimentally testing a knowledge-and-appraisal model of personality architecture among smokers contemplating high-risk situations. Journal of Personality, 76(4), 929–968. https://doi.org/10.1111/j.1467-6494.2008.00510.x.
Colella, K. M., & DeLuca, G. (2004). Shared decision making in patients with newly diagnosed prostate cancer: A model for treatment education and support. Urologic Nursing, 24(3), 187–191 195-196.
Davison, B. J., & Degner, L. F. (1997). Empowerment of men newly diagnosed with prostate cancer. Cancer Nursing, 20(3), 187–196. https://doi.org/10.1097/00002820-199706000-00004.
Davison, B. J., Parker, P. A., & Goldenberg, S. L. (2004). Patients’ preferences for communicating a prostate cancer diagnosis and participating in medical decision-making. BJU International, 93(1), 47–51. https://doi.org/10.1111/j.1464-410X.2004.04553.x.
De Sousa, A., Sonavane, S., & Mehta, J. (2012). Psychological aspects of prostate cancer: A clinical review. Prostate Cancer and Prostatic Diseases, 15(2), 120–127. https://doi.org/10.1038/pcan.2011.66.
Denis, L. J., Roobol, M., & Dourcy-Belle-Rose, B. (2011). Prostate cancer from the horizon of the patient. Acta Oncologica, 50(Suppl.1), 148–154. https://doi.org/10.3109/0284186X.2010.528446.
Denis, L., Joniau, S., Bossi, A., Baskin-Bey, E., & Fitzpatrick, J. M. (2012). PCA: Prostate cancer, patient-centred approach or both? BJU International, 110(1), 16–22. https://doi.org/10.1111/j.1464-410X.2011.10859.x.
Echlin, K. N., & Rees, C. E. (2002). Information needs and information-seeking behaviors of men with prostate cancer and their partners: A review of the literature. Cancer Nursing, 25(1), 35–41.
Edwards, A., & Elwyn, G. (1999). The potential benefits of decision aids in clinical medicine. JAMA, 282(8), 779–780. https://doi.org/10.1001/jama.282.8.779.
Ezer, H., Chachamovich, J. R., Saad, F., Aprikian, A., & Souhami, L. (2012). Psychosocial adjustment of men during the first year of prostate cancer. Cancer Nursing, 35(2), 141–147. https://doi.org/10.1097/NCC.0b013e31821f1b81.
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D. M., Forman, D., & Bray, F. (2015). Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer, 136(5), E359–E386. https://doi.org/10.1002/ijc.29210.
Fiedler, K. (1988). Emotional mood, cognitive style, and behavior regulation. In K. Friedler & J. Forgas (Eds.), Affect, cognition, and social behavior (pp. 110–119). Toronto: Hogrefe Int.
Fischer, M., Visser, A., Voerman, B., Garssen, B., van Andel, G., & Bensing, J. (2006). Treatment decision making in prostate cancer: Patients’ participation in complex decisions. Patient Education and Counseling, 63(3), 308–313. https://doi.org/10.1016/j.pec.2006.07.009.
Fleissig, A., Jenkins, V., Catt, S., & Fallowfield, L. (2006). Multidisciplinary teams in cancer care: Are they effective in the UK? The Lancet Oncology, 7(11), 935–943. https://doi.org/10.1016/S1470-2045(06)70940-8.
Galotti, K. M. (2007). Decision structuring in important real-life choices. Psychological Science, 18(4), 320–325. https://doi.org/10.1111/j.1467-9280.2007.01898.x.
Gwede, C. K., Pow-Sang, J., Seigne, J., Heysek, R., Helal, M., Shade, K., Cantor, A., & Jacobsen, P. B. (2005). Treatment decision-making strategies and influences in patients with localized prostate carcinoma. Cancer, 104(7), 1381–1390. https://doi.org/10.1002/cncr.21330.
Heidenreich, A., Bellmunt, J., Bolla, M., Joniau, S., Mason, M., Matveev, V., Mottet, N., Schmidt, H. P., van der Kwast, T., Wiegel, T., & Zattoni, F. (2011). EAU guidelines on prostate cancer. Part 1: Screening, diagnosis, and treatment of clinically localised disease. European Urology, 59(1), 61–71. https://doi.org/10.1016/j.eururo.2010.10.039.
Hirai, K., Arai, H., Tokoro, A., & Naka, N. (2009). Self-efficacy, psychological adjustment and decisional-balance regarding decision making for outpatient chemotherapy in Japanese advanced lung cancer. Psychology & Health, 24(2), 149–160. https://doi.org/10.1080/08870440701623124.
Janis, I. L., & Mann, L. (1977). Decision making: A psychological analysis of conflict, choice, and commitment. New York: Free Press.
Janz, N. K., Wren, P. A., Copeland, L. A., Lowery, J. C., Goldfarb, S. L., & Wilkins, E. G. (2004). Patient-physician concordance: Preferences, perceptions, and factors influencing the breast cancer surgical decision. Journal of Clinical Oncology, 22(15), 3091–3098. https://doi.org/10.1200/JCO.2004.09.069.
Llewellyn-Thomas, H. A. (1995). Patients’ health-care decision making: A framework for descriptive and experimental investigations. Medical Decision Making, 15(2), 101–106. https://doi.org/10.1177/0272989X9501500201.
Luce, M. F., Bettman, J. R., & Payne, J. W. (1997). Choice processing in emotionally difficult decisions. Journal of Experimental Psychology. Learning, Memory, and Cognition, 23(2), 384–405. https://doi.org/10.1037/0278-7393.23.2.384.
Magnani, T., Valdagni, R., Salvioni, R., Villa, S., Bellardita, L., Donegani, S., Nicolai, N., Procopio, G., Bedini, N., Rancati, T., & Zaffaroni, N. (2012). The 6-year attendance of a multidisciplinary prostate cancer clinic in Italy: Incidence of management changes. BJU International, 110(7), 998–1003. https://doi.org/10.1111/j.1464-410X.2012.10970.x.
Mann, L., Burnett, P., Radford, M., & Ford, S. (1997). The Melbourne decision making questionnaire: An instrument for measuring patterns for coping with decisional conflict. Journal of Behavioral Decision Making, 10(1), 1–19. https://doi.org/10.1002/(SICI)1099-0771(199703)10:13.0.CO;2-X.
McVea, K. L., Minier, W. C., & Johnson Palensky, J. E. (2001). Low-income women with early-stage breast cancer: Physician and patient decision-making styles. Psycho-Oncology, 10(2), 137–146. https://doi.org/10.1002/pon.503.
Ménard, C., Merckaert, I., Razavi, D., & Libert, Y. (2012). Decision-making in oncology: A selected literature review and some recommendations for the future. Current Opinion in Oncology, 24(4), 381–390. https://doi.org/10.1097/CCO.0b013e328354b2f6.
Mishel, M. H., Germino, B. B., Lin, L., Pruthi, R. S., Wallen, E. M., Crandell, J., & Blyler, D. (2009). Managing uncertainty about treatment decision making in early stage prostate cancer: A randomized clinical trial. Patient Education and Counseling, 77(3), 349–359. https://doi.org/10.1016/j.pec.2009.09.009.
Mohler, J. L., Armstrong, A. J., Bahnson, R. R., Boston, B., Busby, J. E., D’Amico, A. V., Eastham, J. A., Enke, C. A., Farrington, T., Higano, C. S., Horwitz, E. M., Kantoff, P. W., Kawachi, M. H., Kuettel, M., Lee, R. J., MacVicar, G. R., Malcolm, A. W., Miller, D., Plimack, E. R., Pow-Sang, J. M., Roach 3rd, M., Rohren, E., Rosenfeld, S., Srinivas, S., Strope, S. A., Tward, J., Twardowski, P., Walsh, P. C., Ho, M., & Shead, D. A. (2012). Prostate cancer, Version 3.2012: Featured updates to the NCCN guidelines. Journal of the National Comprehensive Cancer Network : JNCCN, 10(9), 1081–1087. https://doi.org/10.6004/jnccn.2012.0114.
Noale, M., Maggi, S., Artibani, W., Bassi, P. F., Bertoni, F., Bracarda, S., Conti, G. N., Corvò, R., Gacci, M., Graziotti, P., Magrini, S. M., Enrici, R. M., Mirone, V., Montironi, R., Muto, G., Pecoraro, S., Porreca, A., Ricardi, U., Tubaro, A., Zagonel, V., Zattoni, F., & Crepaldi, G. (2017). Pros-IT CNR: An Italian prostate cancer monitoring project. Aging Clinical and Experimental Research, 29(2), 165–172. https://doi.org/10.1007/s40520-017-0735-6.
Nota, L., & Soresi, S. (2000). Adattamento italiano del Melbourne decision making questionnaire di Leon Mann (Italian adaptation of Melbourne decision making questionnaire by Leon Mann). Giornale Italiano di Psicologia dell’Orientamento, 1, 38–52.
O’Connor, A. M. (1995). Validation of a decisional conflict scale. Medical Decision Making, 15(1), 25–30. https://doi.org/10.1177/0272989X9501500105.
O’Connor, A., Stacey, D., & Jacobsen, M. (2006). Ottawa personal decision guide. Ottawa: Ottawa Health Research Institute.
Orom, H., Penner, L. A., West, B. T., Downs, T. M., Rayford, W., & Underwood, W. (2009). Personality predicts prostate cancer treatment decision-making difficulty and satisfaction. Psycho-Oncology, 18(3), 290–299. https://doi.org/10.1002/pon.1385.
Petersen, S., Heesacker, M., & deWitt Marsh, R. (2001). Medical decision making among cancer patients. Journal of Counseling Psychology, 48(2), 239–244. https://doi.org/10.1037/0022-0167.48.2.239.
Rolland, J. S. (1999). Parental illness and disability: A family systems framework. Journal of Family Therapy, 21(3), 242–266. https://doi.org/10.1111/1467-6427.00118.
Ruhstaller, T., Roe, H., Thürlimann, B., & Nicoll, J. J. (2006). The multidisciplinary meeting: An indispensable aid to communication between different specialities. European Journal of Cancer, 42(15), 2459–2462. https://doi.org/10.1016/j.ejca.2006.03.034.
Salonen, A., Ryhänen, A. M., & Leino-Kilpi, H. (2014). Educational benefits of internet and computer-based programmes for prostate cancer patients: A systematic review. Patient Education and Counseling, 94(1), 10–19. https://doi.org/10.1016/j.pec.2013.08.022.
Say, R., Murtagh, M., & Thomson, R. (2006). Patients’ preference for involvement in medical decision making: A narrative review. Patient Education and Counseling, 60(2), 102–114. https://doi.org/10.1016/j.pec.2005.02.003.
Scott, S. G., & Bruce, R. A. (1995). Decision-making style: The development and assessment of a new measure. Educational and Psychological Measurement, 55(5), 818–831. https://doi.org/10.1177/0013164495055005017.
Sibilia, L., Schwarzer, R., & Jerusalem, M. (1995). Italian adaptation of the General Self-Efficacy scale. Retrieved 21 April 2016.
Stacey, D., Kryworuchko, J., Bennett, C., Murray, M. A., Mullan, S., & Légaré, F. (2012). Decision coaching to prepare patients for making health decisions: A systematic review of decision coaching in trials of patient decision AIDS. Medical Decision Making, 32(3), E22–E33. https://doi.org/10.1177/0272989X12443311.
Stacey, D., Légaré, F., Col, N. F., Bennett, C. L., Barry, M. J., Eden, K. B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., Thomson, R., & Trevena, L. (2014). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, 4. doi: https://doi.org/10.1002/14651858.CD001431.pub5.
Steginga, S. K., & Occhipinti, S. (2006). Dispositional optimism as a predictor of men’s decision-related distress after localized prostate cancer. Health Psychology, 25(2), 135–143. https://doi.org/10.1037/0278-6133.25.2.135.
Steginga, S. K., Occhipinti, S., Gardiner, R. A. F., Yaxley, J., & Heathcote, P. (2004). Prospective study of men’s psychological and decision-related adjustment after treatment for localized prostate cancer. Urology, 63(4), 751–756. https://doi.org/10.1016/j.urology.2003.11.017.
Street, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling, 74(3), 295–301. https://doi.org/10.1016/j.pec.2008.11.015.
Sullivan, K. R., & Mahalik, J. R. (2000). Increasing career self-efficacy for women: Evaluating a group intervention. Journal of Counseling & Development, 78(1), 54–62. https://doi.org/10.1002/j.1556-6676.2000.tb02560.x.
Valdagni, R. (2016). Multidisciplinary team meetings in cancer care: We could and should do better than this. Clinical Oncology, 28(12), 799–800.
Valdagni, R., Van Poppel, H., Aitchison, M., Albers, P., Berthold, D., Bossi, A., Brausi, M., Denis, L., Drudge-Coates, L., De Santis, M., Feick, G., Harrison, C., Haustermans, K., Hollywood, D., Hoyer, M., Hummel, H., Mason, M., Mirone, V., Müller, S. C., Parker, C., Saghatchian, M., Sternberg, C. N., Tombal, B., van Muilekom, E., Watson, M., Wesselmann, S., Wiegel, T., Magnani, T., & Costa, A. (2015). Prostate cancer unit initiative in Europe: A position paper by the European School of Oncology. Critical Reviews in Oncology/Hematology, 95(2), 133–143.
van den Bergh, R. C. N., van Vugt, H. A., Korfage, I. J., Steyerberg, E. W., Roobol, M. J., Schröder, F. H., & Essink-Bot, M. L. (2010). Disease insight and treatment perception of men on active surveillance for early prostate cancer. BJU International, 105(3), 322–328. https://doi.org/10.1111/j.1464-410X.2009.08764.x.
van den Bergh, R. C. N., Korfage, I. J., & Bangma, C. H. (2012). Psychological aspects of active surveillance. Current Opinion in Urology, 22(3), 237–242. https://doi.org/10.1097/MOU.0b013e328351dcb1.
Villani, D., Cognetta, C., Toniolo, D., Scanzi, F., & Riva, G. (2016). Engaging elderly breast cancer patients: The potential of eHealth interventions. Frontiers in Psychology, 7, 1825. https://doi.org/10.3389/fpsyg.2016.01825.
Villani, D., Caputo, M., Balzarotti, S., & Riva, G. (2017). Enhancing self-efficacy through a blended training: A pilot study with basketball players. International Journal of Sport and Exercise Psychology, 15(2), 160–175. https://doi.org/10.1080/1612197X.2015.1079921.
Whelan, T., Levine, M., Willan, A., Gafni, A., Sanders, K., Mirsky, D., Chambers, S., O'Brien, M. A., Reid, S., & Dubois, S. (2004). Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: A randomized trial. JAMA, 292(4), 435–441. https://doi.org/10.1001/jama.292.4.435.
Williams, R. M., Davis, K. M., Luta, G., Edmond, S. N., Dorfman, C. S., Schwartz, M. D., Lynch, J., Ahaghtou, C., & Taylor, K. L. (2013). Fostering informed decisions: A randomized controlled trial assessing the impact of a decision aid among men registered to undergo mass screening for prostate cancer. Patient Education and Counseling, 91(3), 329–336. https://doi.org/10.1016/j.pec.2012.12.013.
Wood, R., & Bandura, A. (1989). Impact of conceptions of ability on self-regulatory mechanisms and complex decision making. Journal of Personality and Social Psychology, 56(3), 407–415. https://doi.org/10.1037/0022-3514.56.3.407.
Zeliadt, S. B., Ramsey, S. D., Penson, D. F., Hall, I. J., Ekwueme, D. U., Stroud, L., & Lee, J. W. (2006). Why do men choose one treatment over another? A review of patient decision making for localized prostate cancer. Cancer, 106(9), 1865–1874. https://doi.org/10.1002/cncr.21822.
Zeliadt, S. B., Penson, D. F., Moinpour, C. M., Blough, D. K., Fedorenko, C. R., Hall, I. J., Smith, J. L., Ekweme, D. U., Thompson, I. M., Keane, T. E., & Ramsey, S. D. (2011). Provider and partner interactions in the treatment decision-making process for newly diagnosed localized prostate cancer. BJU International, 108(6), 851–856. https://doi.org/10.1111/j.1464-410X.2010.09945.x.
Acknowledgements
The authors would like to acknowledge the Prostate Cancer Program Multidisciplinary Team at Fondazione IRCCS Istituto Nazionale dei Tumori; Fondazione Italo Monzino, Milan, Italy, for supporting the psychological counseling to patients with prostate cancer and their partners.
Funding
Financial support for this study was provided in part by a grant from Foundation I. Monzino. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosure of potential Conflict of Interest
Lara Bellardita declares that she has no conflict of interest. Daniela Villani declares that she has no conflict of interest. Silvia Villa declares that she has no conflict of interest. Claudia Repetto declares that she has no conflict of interest. Simona Donegani declares that she has no conflict of interest. Antonella Marchetti declares that she has no conflict of interest. Davide Massaro declares that he has no conflict of interest. Roberto Salvioni declares that he has no conflict of interest. Tiziana Magnani declares that she has no conflict of interest. Riccardo Valdagni declares that he has no conflict of interest.
Research Involving Human Participants and/or Animals
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Bellardita, L., Villani, D., Villa, S. et al. The role of individual characteristics in predicting decisional conflict for patients with prostate cancer (PCa): preliminary results. Curr Psychol 39, 354–363 (2020). https://doi.org/10.1007/s12144-017-9753-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-017-9753-y