Changes in decisional conflict and decisional regret in patients with localised prostate cancer

Abstract

Aims and objectives: To identify the changes and associated factors in decisional conflict and regret in patients with localised prostate cancer up to six months postprimary treatment.

Background: Various treatments of differing qualities can be used for patients with localised prostate cancer; these treatments may cause conflicts in treatment decision-making and post-treatment regret.

Design: A quantitative longitudinal study.

Methods: A total of 48 patients were recruited from a 3700-bed medical centre in northern Taiwan and assessed at pretreatment and one and six months post-treatment. Demographic characteristics, clinical information and results from the psychosocial adjustment to illness scale, decisional conflict scale and decision regret scale were collected. Data were analysed based on the generalised estimating equations models.

Results: The overall decisional conflict substantially improved over time. However, the feeling of being less informed was high and did not improve considerably during the study period. Education level, decision preferences and psychosocial adjustment were associated with decisional conflict and influenced decision-making. The feeling of ineffective decision-making and decisional regret was low, post-treatment. Psychosocial adjustment was associated with effective decision-making and decisional regret.

Conclusion: In patients with localised prostate cancer, decisional conflict reduced considerably up to six months post-treatment. Moreover, the patients were satisfied with their treatment decision-making and believed that they had made the correct choice up to six months post-treatment. However, patients may have experienced feelings of being less informed pre- and post-treatment, particularly those with lower education levels, a preference for passive roles, or inferior psychosocial adjustment. Consequently, health professionals must provide adequate medical information and psychosocial intervention to help patients in the decision-making process.

Relevance to clinical practice: Nurses and healthcare providers must provide localised prostate cancer patients with adequate information and psychosocial intervention to reduce decisional conflict.

Keywords: decision-making; prostate cancer; psychology.