Holmes-Rovner Margaret, Price Chrystal, Rovner David R, Kelly-Blake Karen, Lillie Janet, Wills Celia, Bonham Vence L
Department of Medicine and Center for Ethics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA.
J Gen Intern Med. 2006 Jan;21(1):56-60. doi: 10.1111/j.1525-1497.2005.0280.x.
To use qualitative methods to explore audiotape evidence of unanticipated confusion between benign prostatic hyperplasia (BPH) and prostate cancer in using a videotape BPH treatment decision aid (DA).
Qualitative analysis of semi-structured interviews and surveys originally collected to study men's interpretation of a DA.
Community sample of college and noncollege educated African American and white men (age> or =50; n=188).
Transcript analysis identified themes in men's comments about BPH and cancer. Surveys measured BPH general and prostate cancer-specific knowledge, literacy (Short Test of Functional Health Literacy in Adults), BPH symptoms, and demographics.
In transcript analysis, 18/188 men spontaneously talked about BPH and cancer as being related to each other, despite explicit statements to the contrary in the video. Survey data suggest that up to 126/188 men (67%) persisted in misconceptions even after viewing the DA video. Three themes were identified in the transcripts: (1) BPH and cancer are equated, (2) BPH surgery is for the purpose of removing cancer, and (3) BPH leads to cancer.
Overall knowledge increases with DA use may mask incorrect theories of disease process. Further research should identify decision support designs and clinical counseling strategies to address persistence of beliefs contrary to new information presented in evidence-based DAs.
运用定性方法，探究在使用录像形式的良性前列腺增生（BPH）治疗决策辅助工具（DA）时，出现的良性前列腺增生与前列腺癌意外混淆的录音证据。
对最初为研究男性对决策辅助工具的理解而收集的半结构化访谈和调查进行定性分析。
具有大学学历和非大学学历的非裔美国人和白人男性的社区样本（年龄≥50岁；n = 188）。
转录分析确定男性关于BPH和癌症评论中的主题。调查测量BPH一般知识和前列腺癌特定知识、素养（成人功能性健康素养简短测试）、BPH症状及人口统计学特征。
在转录分析中，188名男性中有18人自发谈到BPH和癌症相互关联，尽管视频中有明确相反的表述。调查数据表明，即使观看了决策辅助工具视频后，仍有多达126/188名男性（67%）坚持错误观念。转录本中确定了三个主题：（1）BPH和癌症被等同；（2）BPH手术旨在切除癌症；（3）BPH会导致癌症。
使用决策辅助工具后整体知识的增加可能掩盖了对疾病过程的错误理论。进一步的研究应确定决策支持设计和临床咨询策略，以解决与循证决策辅助工具中呈现的新信息相悖的信念持续存在的问题。
