Limited Evidence of Shared Decision Making for Prostate Cancer Screening in Audio-Recorded Primary Care Visits Among Black Men and their Healthcare Providers.

Autor:	Stevens, Elizabeth R., Thomas, Jerry, Martinez-Lopez, Natalia, Fagerlin, Angela, Ciprut, Shannon, Shedlin, Michele, Gold, Heather T., Li, Huilin, Davis, J. Kelly, Campagna, Ada, Bhat, Sandeep, Warren, Rueben, Ubel, Peter, Ravenell, Joseph E., Makarov, Danil V.
Předmět:	HEALTH literacy MEDICAL history taking PROSTATE-specific antigen AFRICAN Americans QUALITATIVE research DIVERSITY & inclusion policies RESEARCH funding EARLY detection of cancer PRIMARY health care PROSTATE tumors DECISION making QUANTITATIVE research UNCERTAINTY DESCRIPTIVE statistics JUDGMENT sampling SOUND recordings THEMATIC analysis MEN'S health PHYSICIAN-patient relations ONCOLOGISTS HEALTH promotion GROUNDED theory DATA analysis software QUALITY assurance PATIENTS' attitudes
Zdroj:	Journal of Immigrant & Minority Health; Oct2024, Vol. 26 Issue 5, p866-877, 12p
Abstrakt:	Prostate-specific antigen (PSA)-based prostate cancer screening is a preference-sensitive decision for which experts recommend a shared decision making (SDM) approach. This study aimed to examine PSA screening SDM in primary care. Methods included qualitative analysis of audio-recorded patient-provider interactions supplemented by quantitative description. Participants included 5 clinic providers and 13 patients who were: (1) 40–69 years old, (2) Black, (3) male, and (4) attending clinic for routine primary care. Main measures were SDM element themes and "observing patient involvement in decision making" (OPTION) scoring. Some discussions addressed advantages, disadvantages, and/or scientific uncertainty of screening, however, few patients received all SDM elements. Nearly all providers recommended screening, however, only 3 patients were directly asked about screening preferences. Few patients were asked about prostate cancer knowledge (2), urological symptoms (3), or family history (6). Most providers discussed disadvantages (80%) and advantages (80%) of PSA screening. Average OPTION score was 25/100 (range 0–67) per provider. Our study found limited SDM during PSA screening consultations. The counseling that did take place utilized components of SDM but inconsistently and incompletely. We must improve SDM for PSA screening for diverse patient populations to promote health equity. This study highlights the need to improve SDM for PSA screening. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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