Bakgrunn og føremål: Aktiv overvaking av prostatakreft med saktevaksande svulst med lågrisiko. Our study of a large modern cohort of men with low-risk PCa demonstrates significant lower receipt of DT, lower receipt of prostatectomy among those receiving DT, and lower survival for black men compared to their white counterparts. Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av prostatakreft 3 Forord Nasjonale handlingsprogram med faglige retningslinjer for kreft skal bidra til at det offentlige However, in the literature, much less attention has been paid to the opinions of urologists. Cancer-specific anxiety decreased among Decipher risk categories in both arms. Participants with early stage tumors (n = 28) typically perceived only one treatment option and followed the physician’s recommendation. You can request the full-text of this article directly from the authors on ResearchGate. Remissrunda 1 - Nationellt vårdprogram för Remissrunda 1 - Nationellt vårdprogram för prostatacancer Den nationella vårdprogramgruppen för prostatacancer har arbetat fram ny version av nationellt vårdprogram för prostatacancer samt en kortversion för allmänläkare. Transcripts were analyzed deductively using themes from the Health Belief Model, and inductively to explore emergent themes. Of 119 men approached, 108 (90%) were interviewed; 91% reported non-systematic decision processes, with deferral to the doctor, positive and negative recollections of others' cancer experiences, and the pre-existing belief that surgery is a better cancer treatment being most common. These findings suggest that infographics may be of higher relative value to participants with low health literacy. Men preferred collaborative (35%) or semi-active (35%) decision-making roles. Prostate 9999: XX–XX, 2015. WHAT IS QUALITATIVE RESEARCH? To assess localized prostate cancer (PC) patients' understanding of the differences in outcomes and risks of radical prostatectomy (RP), radiotherapy (RT), and active surveillance (AS), and to identify correlates of misperceptions. Participants who reflected on their decision processes showed decreased amounts of processing, suggesting that introspection limited their ability to systematically process information. Our study examined how risk for prostate cancer is perceived and experienced by patients undergoing active surveillance with their clinicians, how risk is communicated in clinical consultations, and the implications for treatment and care. Evaluation of cytotoxicity and genetic changes of high dose vitamin C infusions castration resistant metastatic human prostate cancer Martin Højgaard & Torben Kjær Nielsen Herlev Hospital - Department of Urology Side 2 of 42 Patients who received DT had better survival. Challenges of decisions regarding urinary reconstruction were dominant. The EU Clinical Trials Register currently displays 40958 clinical trials with a EudraCT protocol, of which 6694 are clinical trials conducted with subjects less than 18 years old. Similarly, Gwede et al. Det här är behandling som man får för att bli frisk från cancer. Respondents provided basic demographic information (age, education and marital status). %PDF-1.4 %���� The longitudinal multilevel models showed significant associations between the patient-provider communication in terms of devotion, support and co-therapy and functional aspects of HRQoL. We conducted an observational study, using an eye tracker device, of how men with newly diagnosed localized prostate cancer visually engaged with an on-screen infographic depicting risk information in the Personal Patient Profile-Prostate. 4. Acceptability for Personal Patient Profile-Prostate was high. The risky choice framing effect (FE) pertains to the systematic preference reversal because different aspects of formally identical situations are emphasized. Patient-provider communication is a valuable resource to support prostate cancer patients' coping with the disease and to improve their HRQoL. The clinical utility of the Decipher test was evaluated prospectively on postoperative treatment decisions and patient-reported outcomes. Decision aids were found to be feasible and acceptable to patients and to increase the agreement between patients' values and decisions and patients' knowledge. 0000004091 00000 n in particular, increased negative emotion leads to more attribute-based processing at the beginning of the decision process. Ethnic- and gender-specific concept maps were not analysed because of high similarity in their sorting patterns. Hypocampus är en ordlek på Hippocampus, en del av hjärnan som hjälper oss att lagra minnen. Grounded theory, phenomenology, and ethnography are qualitative research strategies often implemented by those researchers who are compelled to gather rich descriptions of their interest areas (4). On the basis of this extended framework, the authors hypothesized and found in 3 experiments that decision processing under increasing negative emotion both becomes more extensive and proceeds more by focusing on one attribute at a time. The authors conclude that there is a significant association between patients' preferences for risk communication with their physicians in terms of words only and a tendency to prefer early surgical intervention for prostate cancer when surgical risk data are provided numerically. Thus, using the Comprehensive Model of Health Information (CMIS) framework, we assessed the antecedent factors, information carrier factors, and information-seeking activities in localized prostate cancer patients. Health communication scientists may find incorporating the behavioral decision research framework enriches the disciplinary inquiry of health information seeking, while information scientists could use it to commence the cognitive turn of information science evolution. Nationella riktlinjer för bröst-, prostata-, tjocktarms- och ändtarmscancervård •Berör de tre cancerdiagnoser som drabbar flest människor. Surveys were conducted at a median 25 days (range 9-100) post diagnosis. Diagnostik og udredning af prostata Additional prospective studies are needed to explore the decision process from a family perspective. We retrospectively reviewed 4,610 patients undergoing radical prostatectomy between 1990 and 2011. There is little medical evidence to support the "best" option for most men diagnosed with LPC and therefore men often are asked to contribute to the care or treatment decision. A linear regression model was estimated. The other ones are a series of interviews. 0000003832 00000 n Definitive treatment (DT) was defined as undergoing radiotherapy or prostatectomy. Results People sometimes treat safety and danger categorically, undervalue the importance of a partial risk reduction, are influenced by the way in which a problem is framed, and inappropriately evaluate an action by its subsequent outcome. 2.200 til 4.500. Tumor blood vessel density was decreased both after castration and Linomide treatment alone, 40 and 32% respectively. The data corroborated American Cancer Society findings that national cancer resources are not being used effectively by this population and reinforced the need for a multidisciplinary approach to the management of prostate cancer. Men in the collaborative group and those who wanted their physician to make treatment decisions-only after seriously considering their opinions-also wanted significantly more information in these three categories. When choosing between surgery and radiation, participants' choices were indeed influenced by the naming of the treatment, but not exclusively-they generally preferred surgery, and when it was offered in terms of losses, they preferred it even more. The decision aid, a tape and workbook, includes explicit presentation of probabilities, photographs and graphics, and a values clarification exercise. Further, a series of regression analyses explored mediation of the relationship between attitudes to seeking help and support service use by behavioural intentions. We suggest that an awareness of how people reason is an important clinical skill that can be promoted by knowledge of selected past studies in psychology. Results: The mean age of the men was 68.38 years, and most lived with their spouse or partner (94.1%). University Of The West Indies, Open Campus, Factors Influencing Patients' Treatment Selection for Localised Prostate Cancer: A Systematic Review, The frame and name of the medical treatment and their influence on health decisions, The Conflicts of Decision-Making for Localized Prostate Cancer (LPC) Treatments, The accuracy of patients’ perceptions of the risks associated with localized prostate cancer treatments. +4722935791; Publications 2021. alone or in conjunction with castration to rats bearing the Dunning R-3327 PAP rat prostate tumor and its effect on tumor growth analyzed. more questions are raised than answered and the debate goes on: Is surgery Sociodemographic variables accounted for only 15% of variance in preferences. Further research will be conducted in a diverse sample of patients making decisions in a non-urban, community setting. Moreover, introspection participants indicated that they did not weight the information as they should have, countering the possibility that they adapted their strategies to better meet decision context demands. 0000002148 00000 n With the growing interest in behavioral health and medical decision-making, this systematic integrative review aims to understand research on cognitive biases in the context of consumer health information seeking and where future research opportunities may reside. %%EOF Empirical support was found for the application of attribution theory in the models of performance appraisal. Themes identified in the studies included: the importance of patient perceptions of treatment efficacy and side effects; the influence of physician recommendations on patient decision-making; and the prioritization of concerns regarding treatment side effects among those men who prefer radiation therapy or active surveillance. The authors review a specific open-ended protocol analysis for assessing cognitive structures and processes--the thought-listing technique. Using panel data collected from 224 women diagnosed with breast cancer, worry was found to predict patients' health information seeking via the perceived need for additional information. Patients have been known to have great difficulty making prostate cancer treatment decisions given the perceived uncertainty about the ideal treatment, and, therefore, seek out many different opinions [22, ... For those considering active treatment, few findings from prospective randomized trials in North American settings adequately compare the modalities on survival or adverse outcomes such as erectile, bladder, and bowel dysfunction. Usability issues were discovered that are potential barriers to effective decision support. Reductions in anxiety were specifically observed for patients with a higher monitoring coping style and patients for whom a treatment plan without chemotherapy was proposed. Older men (p = 0.02) and men living alone (p = 0.048) received less information than others. However, little has been said about the types of support and information needed or the best way to deliver them. The positive surgical margin rate was 24.2% and the positive lymph node rate was 1.1%. Ethnic groups and genders had similar sorting, but some variation in importance. Radiol 2007; Scheidler Radiol1999 T2W+DWI: 85% Haider AJR 2007; Miao Eur J Rad 2007 T2W+DCE: 85% Ito Br J Radiol 2003, Futterer Radiol 2006 T2W+DWI+DCE: 90% Futterer, Radiol 2006 Accuracy: Mål for hvor godt en test identificerer eller udelukker en tilstand The journey of men diagnosed with low-volume, potentially non-aggressive prostate cancer may be a multifaceted one. State anxiety was associated with higher DC across all subscales.Conclusions These variables are not particularly useful in making predictions about which groups want more or less active roles in medical decision making. A total of 1893 questionnaires at t0 (initial diagnosis) and t1 (six months after diagnosis) were analyzed. ¾ Lægevidenskabelig embedseksamen Århus Universitet sommer1978. More than half of the patients did not comprehend that RP patients are at greater risk for incontinence (65%, n=202) and erectile dysfunction (61%, n=190), and less at risk for bowel problems (53%, n=211) compared to RT patients. The mechanisms through which introspection affects decision quality are discussed. Although most patients with prostate cancer prefer an active or collaborative role in treatment decision-making [23], most do not use information about medical treatments comprehensively or systematically. At the bivariate level, factors associated with the belief that the treatment chosen was best were as follows: White race/ethnicity, higher levels of education, a more recent treatment date, having health insurance coverage, type of treatment received, higher levels of bother from side effects, greater contentment with their quality of life, and doctor discussions of the various treatment options. Older patients were significantly (P < .002) more likely to prefer expectant management. been part of routine cancer care. Three studies measured these factors whilst patients were considering the treatments available to them [14. We used MAUT to model prostate cancer patients' preferences for their own health state and we compared this model to patients' global judgments of health state utility. Interestingly, high monitors for whom treatment without chemotherapy was proposed showed a major decrease in anxiety, whereas low monitors for whom treatment starting with chemotherapy was proposed showed a great increase in anxiety. In consultation with the physician the patient select treatment. In the domain of health, the effect of framing of choice between alternative treatments might be influenced by pre-existing beliefs about treatments held by patients. Post-Decipher treatment recommendation was administered 78% and 76% of the time in the ART and SRT arms, respectively. Objective: The results are inconsistent with views that negative emotion acts only as an incentive or only as a source of decision complexity. Men diagnosed with localised prostate cancer (LPCa) are usually offered a range of treatment options. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer. PLAY. Results: In this chapter, the acceptance and opinions of American and Dutch urologists regarding AS will be discussed and compared. Patienter med lav eller intermediær risiko prostatacancer kan tilbydes initiel UMEÅ UNIVERSITY MEDICAL DISSERTATIONS New Series No 1035 - ISSN 0346-6612 - ISBN 91-7264-125-8 From the Department of Radiation Sciences, Oncology, and Department of Nursing, The diagnostic phase is associated with high levels of anxiety. Video recorded patient-oncologist clinical interactions (n = 103) from outpatient clinics of two urban cancer hospitals (including a National Cancer Institute-designated comprehensive cancer center) were analyzed. In the domain of emotions, people tend to consider losses as more significant than the corresponding gains, are imperfect at predicting future preferences, distort their memories of past personal experiences, have difficulty resolving inconsistencies between emotions and rationality, and worry with an intensity disproportionate to the actual danger. High- and low-task-importance Ss read a strong or weak unambiguous message or an ambiguous message that was attributed to a high- or low-credibility source. The survival difference was most striking among the elderly. Uncertainty about probabilities for cure was reported by 43% of men and fear of cancer spread by 37%. Younger patients (OR = 1.06 per year; CI = 1.02-1.10, p = 0.0008) and those wanting risk communication in terms of words only (OR = 2.41; CI = 1.24-4.70, p = 0.01) tended to prefer surgery-now over watchful waiting as the management strategy for asymptomatic gland-confined prostate carcinoma. A cutoff score (>44) was used to indicate highly anxious patients. In contrast, control participants appeared to use heuristic and systematic processing interdependently. Our findings led to revisions further refining the usability and linguistic and cultural appropriateness of Spanish P3P. Conclusions: Results: Dersom det for kvar kreftdiagnose vart brukt like mykje strålebehandling som i det fylket der forbruket var høgast, ville berre 450 henvisningar ha mangla i helseregionen i 2007. Valda sjukdomar är hjärtsvikt, prostatacancer och Kroniskt obstruktiv lungsjukdom (KOL) sjukdomsportfolio hjärtsvikt, ENDO-AID CADe The [AI]d in Endoscopy ENDO-AID CADe is a computer-aided detection application that uses AI to suggest . Methods and materials: However, there is limited research on how children's functioning is affected by parental cancer, and the impact of parenting concerns on treatment decisions. Objectives: ... Also, half of the participants identified both the urologist and radiation oncologist as most helpful for decision-making. Methods: Sessions were audiotaped, transcribed verbatim, and analyzed using thematic content analysis techniques. However, radical prostatectomy was significantly predicted by participants' propensity to take risks. Participants held positive views about the roles and potential impact of PCSGs. In addition, we will make a case for the importance of including parenting issues in cancer care, and in assessments of treatment decision-making and quality of life. The study of heuristics and biases in judgement has been criticized in several publications by G. Gigerenzer, who argues that "biases are not biases" and "heuristics are meant to explain what does not exist" (1991, p. 102). In the beginning of the study all persons in the Southern Health Care Region in Sweden diagnosed with colon, rectal, breast, prostate and lung . The importance of parenting concerns among patients with cancer, Prospective predictors of psychosocial support service use after cancer. their patients without definitive answers to these pressing questions. Conclusion: The majority (59%) of patients wanted physicians to make treatment decisions on their behalf, but 64% of the public thought they would want to select their own treatment if they developed cancer. Previous research has considered the question of how anticipated regret affects risky decision making. Tumören är vanligen mycket långsamt växande i tidigt skede. RADS fagudvalg. The FE was registered only in the first and the second condition, and it was moderate and strong, respectively. STUDY. KIRURGEN 3-2021 I 187. The HRQoL of the patients shows substantial variation over time and between the reported subscales (Global Qol 71,1-77,2; physical functioning 89,1-92,1; role functioning 81,0-88,1; emotional functioning 74,4-84,0; cognitive functioning 84,3-87,7; social functioning 77,7-84,0). Relative to other symptoms, difficulty swallowing and feeling sad were the strongest drivers of decisional regret. 0000000716 00000 n Of those selecting observation, 80% (47/59) reported being most influenced by the complications of an operation. 589 21 The aim of this systematic review was to examine the role of these beliefs in influencing treatment selection in LPCa. Curriculum Vitae: Jens Fromholt Larsen 3 Uddannelse: ¾ Studentereksamen Randers statsskole mat/fys sommer1970. A two-part questionnaire measured the type and amount of information preferred. Background: Each stage of bladder cancer involves varying treatment issues and concerns that are discussed between patients and providers during the pre-treatment consultation.

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