Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany.
Support Care Cancer. 2012 Apr;20(4):791-7. doi: 10.1007/s00520-011-1151-7. Epub 2011 Apr 12.
Whilst much is known as to the met and unmet communication needs of prostate cancer patients, few studies have been conducted on the changes in communication between provider and patient over time. Therefore, the aim of our study is to examine (a) whether there are changes over time in the quality of psychosocial care in long-term treatment of localized prostate cancer and (b) whether those changes are associated with the treatment decision.
HAROW is a prospective, observational study designed to collect clinical data and patient reported outcomes (PROs) of different treatment options (hormonal therapy, active surveillance, radiation, operation, watchful waiting) for newly diagnosed patients with localized prostate cancer under real conditions. At 6-month intervals, general clinical data, PROs (e.g. quality of life, quality of physician-patient interaction) and individual costs are documented. We analysed data of N = 1,216 patients at the time of initial diagnosis (T1) and after 6 months (T2).
There is a significant decline in shared decision-making behaviour of physicians for the group of patients undergoing a prostatectomy and for the hormonal therapy group at the time of initial diagnosis and after 6 months. In terms of emotional support by physicians, there is a significant difference between the treatment groups at the time of initial diagnosis with patients undergoing a prostatectomy reporting significantly less support than the hormonal therapy group.
Future research from both, the providers' and the patients' perspective, will have to clarify if we can interpret our results as change in the communication behaviour once the treatment decision for prostatectomy or hormonal therapy is made.
尽管人们已经了解了前列腺癌患者的沟通需求和未满足需求，但很少有研究关注提供者和患者之间的沟通随时间的变化。因此，我们的研究旨在检查：（a）在局部前列腺癌的长期治疗中，心理社会护理的质量是否随时间发生变化；（b）这些变化是否与治疗决策相关。
HAROW 是一项前瞻性观察性研究，旨在收集不同治疗选择（激素治疗、主动监测、放疗、手术、观察等待）的新诊断局部前列腺癌患者的临床数据和患者报告结果（PROs）。在 6 个月的间隔内，记录一般临床数据、PROs（如生活质量、医患互动质量）和个体成本。我们分析了 1216 名患者在初始诊断时（T1）和 6 个月后（T2）的数据。
在初始诊断和 6 个月后，接受前列腺切除术的患者组和接受激素治疗的患者组的医生共享决策行为明显下降。在医生提供的情感支持方面，治疗组在初始诊断时存在显著差异，接受前列腺切除术的患者报告的支持明显少于接受激素治疗的患者。
未来的研究必须从提供者和患者的角度来阐明，我们是否可以将我们的结果解释为一旦做出前列腺切除术或激素治疗的治疗决策，沟通行为的变化。
