Influence of a patient decision aid on decisional conflict related to PSA testing: a structural equation model
| Autor: | Ye Xu, E. Wayne Holden, Lawrence E. Scholl, Robert L. Stephens, Robert J. Volk, Leonardo A. Stroud, Stephanie L. Kamin |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Patients Population Decision Making Psychological intervention Prostatic Hyperplasia Decisional conflict Structural equation modeling Developmental psychology Conflict Psychological Schema (psychology) medicine Humans education Applied Psychology Aged education.field_of_study Prostatic Neoplasms Middle Aged Prostate-Specific Antigen Helping Behavior Risk perception Psychiatry and Mental health Prostate cancer screening Anxiety Female medicine.symptom Psychology Attitude to Health |
| Zdroj: | Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 27(6) |
| ISSN: | 0278-6133 |
| Popis: | Objective To examine the impact of a decision aid (DA) designed to promote informed decision making for screening with the prostate-specific antigen (PSA) test and to test a theoretical model of factors influencing decisional conflict. Design Structural equation modeling examined pathways between DA exposure, knowledge, schema, prostate cancer risk perceptions, decisional anxiety, and decisional conflict. Sample participants included 200 men from the general population (exclusive of African Americans) and 200 African American men. Half of the men in each subsample were randomly assigned to receive the DA. Main outcome measures Decisional conflict regarding prostate cancer screening. Results The DA influences level of decisional conflict by increasing patient knowledge. This effect of knowledge on decisional conflict is indirect, however, through an association with greater perceived risk and lower decisional anxiety. Also, positive PSA schema was associated with lower decisional anxiety and decisional conflict. It is important that exposure to the DA had no impact on PSA schema. Conclusion Schemas about testing must be considered in developing messages about the risks and benefits of testing. If schemas are counter to message content, mechanisms for modifying schemas must be incorporated into interventions. |
| Databáze: | OpenAIRE |
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