Purpose

Information about prostate cancer patients’ experiences with their treatment is crucial to optimize shared decision-making. This study examined unmet expectations in prostate cancer patients and their association with decision regret.

Methods

We conducted a prospective, observational, multi-center study of men diagnosed with localized prostate cancer between 2014 and 2016. Questionnaires were completed at baseline (pre-treatment), and up to 12 months after treatment. Unmet expectations were reported as the proportion of patients who experienced side effects as worse than expected. Linear regression analysis was used to identify factors associated significantly (p ≤ 0.05) with unmet expectations and its association with decision regret.

Results

At 1-year follow-up, the majority of the patients (71%, 210/296) reported at least one unmet expectation. The proportion of patients who reported worse than expected erectile problems was 56%, recovery period = 29%, urinary problems = 28%, fatigue = 24%, and bowel problems = 17%. Unmet expectations were comparable between treatment groups, except for fatigue. A passive role in the decision-making process (eta squared (η²) = 0.02) and higher scores on the decisional conflict scale (η² = 0.02) were associated with more unmet expectations, and unmet expectations were associated with decision regret (η² = 0.08).

Conclusions

Unmet expectations are common among men treated for localized prostate cancer. Involving patients in the treatment decision-making process and offering additional counseling to patients who indicate uncertainty about their decision, may help to avoid unmet expectations.

Implications for Cancer Survivors

The current study emphasizes the need for involving prostate cancer patients in the decision-making process in order to mitigate unmet expectations.

中文翻译：

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对前列腺癌患者的期望未得到满足及其与决策遗憾的关系。

目的

有关前列腺癌患者治疗经验的信息对于优化共享决策至关重要。这项研究检查了前列腺癌患者未满足的期望及其与决策遗憾的关系。

方法

我们在2014年至2016年之间对诊断为局部前列腺癌的男性患者进行了一项前瞻性，观察性，多中心研究。调查问卷在基线（治疗前）和治疗后12个月内完成。未达到期望的报告是发生副作用比预期更糟的患者比例。线性回归分析，以确定相关联的显著因子（p 与未满足的期望及其与决定遗憾关联≤0.05）。

结果

在1年的随访中，大多数患者（71％，210/296）报告了至少一项未满足的期望。勃起问题较预期严重的患者比例为56％，恢复期= 29％，泌尿系统疾病= 28％，疲劳= 24％，肠病= 17％。除疲劳外，治疗组之间未满足的期望值是可比较的。在决策过程中被动的角色（ETA的平方（η ²上的决策冲突规模）= 0.02）和更高的分数（η ²  = 0.02），用更多未满足的期望相关联，并且未满足的期望用决定遗憾（相关η ²  = 0.08）。

结论

在接受局部前列腺癌治疗的男性中，未满足的期望很普遍。让患者参与治疗决策过程，并为表明不确定其决策的患者提供额外咨询，可能有助于避免未达到预期的期望。

对癌症幸存者的影响

当前的研究强调需要使前列腺癌患者参与决策过程，以减轻未满足的期望。