Partner participation in prostate cancer treatment decision-making

Men are often torn between involving their family members in health-care decision-making and trying to keep the whole issue to themselves because they just “don’t want to make a big deal about it.” But prostate cancer is a big deal — for the patient and for his immediate family.

Zeliadt et al. set out to investigate the degree  to which partners of prostate cancer patients actually participate in the decision-making process with the patients themselves and with the patients’ providers during the time period between initial diagnosis of prostatew cancer and the initiation of treatment. They did this by recruiting patients with newly diagnosed, localized prostate cancer and their partners from urology practices in three states in the USA.

The patients and their partners were asked to complete take-home surveys after initial biopsy but before initiation of treatment. Partners were specifically asked to describe their roles in the decision-making process, including participation in clinic visits, and perceptions of encouragement from providers to participate in the treatment decision-making process. Partners were also asked to rate their satisfaction with the patients’ providers.

The core findings of the survey were as follows:

  • Individual family members of 80 percent of newly diagnosed patients agreed to participate.
  • Most fasmily members (93 percent) were spouses or significant others (“partners”).
  • Most partners (93 percent) had direct personal contact with the patients’ physicians.
  • Among the partners who had direct personal contact with the patients’ providers
    • 67 percent were very satisfied with the patients’ providers.
    • 80 percent said they were encouraged by the doctor to participate in the treatment decision.
  • 91 percent of partners reported very frequent discussions with their loved one about the pending treatment decision.
  • 69 percent of partners reported that their role was to help the patient make a decision.
  • Provider encouragement of partner participation was associated with higher partner satisfaction (odds ratio [OR] =3.4) and an increased likelihood of partners reporting very frequent discussions with their loved one (OR =6.1).

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