Davison B Joyce, Oliffe John L, Pickles Tom, Mroz Lawrence
Department of Urology, University of British Columbia, Prostate Centre at Vancouver General Hospital, Vancouver, Canada.
Oncol Nurs Forum. 2009 Jan;36(1):89-96. doi: 10.1188/09.ONF.89-96.
PURPOSE/OBJECTIVES: To identify and describe decision-making influences on men who decide to manage their low-risk prostate cancer with active surveillance.
Qualitative, semistructured interview.
The Prostate Centre at Vancouver General Hospital in Canada.
25 patients diagnosed with low-risk prostate cancer and on active surveillance.
An interpretative, descriptive, qualitative design.
Factors that influenced men's decisions to take up active surveillance.
The specialists' description of the prostate cancer was the most influential factor on men choosing active surveillance. Patients did not consider their prostate cancer to be life threatening and, in general, were relieved that no treatment was required. Avoiding treatment-related suffering and physical dysfunction and side effects such as impotence and incontinence was cited as the major reason to delay treatment. Few men actively sought treatment or health-promotion information following their treatment decision. Female partners played a supportive role in the decision. The need for active treatment if the cancer progressed was acknowledged. Patients were hopeful that new treatments would be available when and if they needed them. Being older and having comorbidities did not preclude the desire for future active treatment. Patients carried on with their lives as usual and did not report having any major distress related to being on active surveillance.
The study findings indicate that men are strongly influenced by the treating specialist in taking up active surveillance and planning future active treatments. As such, most men relied on their specialists' recommendation and did not perceive the need for any adjunct therapy or support until the cancer required active treatment.
Oncology nurses should work collaborative-ly with specialists to ensure that men receive the information they need to make informed treatment decisions.
目的/目标：识别并描述影响决定采用主动监测来管理低风险前列腺癌的男性患者的决策因素。
定性、半结构化访谈。
加拿大温哥华总医院前列腺中心。
25名被诊断为低风险前列腺癌且正在接受主动监测的患者。
一种解释性、描述性的定性设计。
影响男性患者选择主动监测的因素。
专家对前列腺癌的描述是男性选择主动监测的最具影响力的因素。患者不认为自己的前列腺癌会危及生命，总体而言，无需治疗让他们感到宽慰。避免与治疗相关的痛苦、身体功能障碍以及阳痿和尿失禁等副作用被认为是延迟治疗的主要原因。很少有男性在做出治疗决定后积极寻求治疗或健康促进信息。女性伴侣在决策中起到了支持作用。患者认识到如果癌症进展则需要积极治疗。患者希望在需要时能有新的治疗方法可用。年龄较大和患有合并症并不妨碍对未来积极治疗的渴望。患者像往常一样继续生活，并未报告因接受主动监测而有任何重大困扰。
研究结果表明，男性在接受主动监测和规划未来积极治疗方面受到主治专家的强烈影响。因此，大多数男性依赖专家的建议，直到癌症需要积极治疗时才意识到需要任何辅助治疗或支持。
肿瘤护理人员应与专家合作，确保男性患者获得做出明智治疗决策所需的信息。
