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Patient participation in treatment decision-making of prostate cancer: a qualitative study

  • Original Article
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Abstract

Purpose

Despite increasing development in decision-making strategies for patients with prostate cancer, little is known about patients’ individual experience and perception throughout the decision-making process. The objective of this study was to explore patients’ experiences and perceptions towards treatment decision-making.

Methods

We conducted a qualitative interview study with 30 patients diagnosed with prostate cancer. We transcribed interviews verbatim and inductively identified codes. Thematic analysis was used to develop and refine a codebook that aided in the identification of themes.

Results

Three key themes and nine subthemes emerged, which were as follows: I. less involved in treatment decision-making, (i) passive decisional control, (ii) lack of medical knowledge, and (iii) domination by family members; II. the right to be informed of the disease condition and to choose treatment options, (i) sociocultural influences, (ii) patients believe that they should know the true facts of the disease, and (iii) patient autonomy during treatment; and III. future consideration and advance care planning, (i) fewer future concerns, (ii) advance care planning is poorly understood, and (iii) acceptance of advance care planning.

Conclusion

The study results show that patients with prostate cancer have a diversity of needs to cultivate their ability to make treatment decisions, and healthcare professionals should empower patients, as well as provide decision aids or decision support for patients.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

Our deepest gratitude goes to both the anonymous reviewers and the editor for their careful work and thoughtful suggestions that have helped improve this paper substantially. Sincere thanks are also due to Prof. Yu Shi, Prof. Junhong Zhu, and Postgraduate Student Ruolin Qiu and Topatana Win, all from Zhejiang University School of Medicine, for their suggestions during revising this paper. We thank Georgia Lenihan-Geels, PhD, from Liwen Bianji (Edanz) (www.liwenbianji.cn/), for editing the English text of a draft of this manuscript. Lastly, we thank all participants of this study for sharing their stories and experiences, without which this project would not be possible.

Funding

This work was supported by Zhejiang Provincial Public Welfare Research Project under Grant No. LGF19H050007 and Zhejiang Provincial Medical and Health Technology Project (grant. 2020KY111).

Author information

Authors and Affiliations

  1. The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Shucheng Pan, Jinjiao Mao, Lijuan Wang, Yun Dai & Wei Wang

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  1. Shucheng Pan
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  2. Jinjiao Mao
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  3. Lijuan Wang
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  4. Yun Dai
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  5. Wei Wang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Shucheng Pan, Jinjiao Mao, and Lijuan Wang. The first draft of the manuscript was written by Shucheng Pan, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Wei Wang.

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Ethics approval

The study was carried out in accordance with the Declaration of Helsinki after approval by the Clinical Research Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (Approved No. 2018–707).

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The authors declare no competing interests.

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Appendices

Appendix

Interview schedule

Main questions

  • How do you make treatment-related decisions?

  • How many people involved in your treatment decision-making? Who are they?

  • What are the difficulties when you make treatment-related decisions?

  • Would you like to be informed of the truth? By whom?

  • Is there any decision or consideration for future? What do you think of advance care planning?

  • Please talk about your views on treatment decision-making?

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Pan, S., Mao, J., Wang, L. et al. Patient participation in treatment decision-making of prostate cancer: a qualitative study. Support Care Cancer 30, 4189–4200 (2022). https://doi.org/10.1007/s00520-021-06753-1

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  • DOI: https://doi.org/10.1007/s00520-021-06753-1

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