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. 2021 Nov-Dec;44(6):E467-E475.
doi: 10.1097/NCC.0000000000000918.

Development of the Prostate Cancer Treatment Decision Framework: A Context-Specific Expansion of the Risk-as-Feelings Hypothesis

Otis L Owens  1 , Robin M Dawson, Tracey Thomas
Affiliations

Development of the Prostate Cancer Treatment Decision Framework: A Context-Specific Expansion of the Risk-as-Feelings Hypothesis

Otis L Owens et al. Cancer Nurs. 2021 Nov-Dec.

Abstract

Background: Over the past 2 decades, numerous decision-making interventions have been developed to guide the prostate cancer (PrCA) treatment choices of patients and families. These interventions are often supported by economic decision frameworks, which do not account for the role of emotions in treatment decisions. In some instances, emotion-driven decisions can override an individual's cognitive evaluation of a decision, leading to unfavorable outcomes such as decision regret.

Objectives: To produce a Prostate Cancer Treatment Decision Framework based on the Risk-as-Feelings Hypothesis.

Methods: The authors reviewed seminal research in emotion and decision-making in an effort to create a context-specific decision framework.

Results: Five variables, not germane to the Risk-as-Feelings Hypothesis, play prominent roles in PrCA decision-making including age, spirituality, family support, healthcare provider communication, and perception of treatment outcomes. While family support only affects decision outcomes by influencing emotion and cognitive evaluation of a PrCA decision, age, spirituality, and healthcare provider communication can have direct effects on an individual's perception of treatment outcomes.

Conclusions: The Prostate Cancer Treatment Decision Framework combines new variables with older models to explain the PrCA treatment decision-making process and elucidate relationships affecting treatment outcomes and survivors' perceptions of these outcomes. The core premise of this model can be applied to other high-risk health decisions.

Implications for practice: Healthcare providers have the greatest influence on PrCA treatment decision-making. Using a shared decision-making approach, providers should take into account a patient's personal characteristics and values, in addition to clinical presentation, to help patients with treatment decisions.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure:
Figure:
Prostate Cancer Treatment Decision Framework. In this framework new variables that were not a part of the original RaFH are notated in blue and existing variables are notated in black. The dashed line denotes the direct/independent relationship that personal characteristics can have with patient perceptions.
See this image and copyright information in PMC

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