Department of Medicine, Section of Geriatrics & Palliative Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA.
J Gen Intern Med. 2012 Aug;27(8):1068-78. doi: 10.1007/s11606-012-2086-5.
Ethnic minorities are disproportionately impacted by prostate cancer (PCa) and are at risk for not receiving informed decision making (IDM). We conducted a systematic literature review on interventions to improve: (1) IDM about PCa in screening-eligible minority men, and (2) quality of life (QOL) in minority PCa survivors.
MeSH headings for PCa, ethnic minorities, and interventions were searched in MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO. SUBJECT ELIGIBILITY CRITERIA: We identified U.S.-based, English-language articles (1985 - 2010) on interventions to improve PCa IDM and QOL that included 50% or more minority patients or analyses stratified by race/ethnicity.
Articles (n = 19) were evaluated and scored for quality using a Downs and Black (DB) system. Interventions were organized by those enhancing 1) IDM about PCa screening and 2) improving QOL and symptom among PCa survivors. Outcomes were reported by intervention type (educational seminar, printed material, telephone-based, video and web-based).
Fourteen studies evaluated interventions for enhancing IDM about PCa screening and five evaluated programs to improve outcomes for PCa survivors. Knowledge scores were statistically significantly increased in 12 of 13 screening studies that measured knowledge, with ranges of effect varying across intervention types: educational programs (13% - 48% increase), print (11% - 18%), videotape/DVD (16%), and web-based (7% - 20%). In the final screening study, an intervention to improve decision-making about screening increased decisional self-efficacy by 9%. Five cognitive-behavioral interventions improved QOL among minority men being treated for localized PCa through enhancing problem solving and coping skills.
Weak study designs, small sample sizes, selection biases, and variation in follow-up intervals across studies.
Educational programs were the most effective intervention for improving knowledge among screening-eligible minority men. Cognitive behavioral strategies improved QOL for minority men treated for localized PCa.
少数民族人群中前列腺癌（PCa）的发病率不成比例，并且存在未获得充分信息的决策制定（IDM）的风险。我们对旨在改善以下方面的干预措施进行了系统文献综述：（1）筛查合格的少数民族男性中关于 PCa 的 IDM，以及（2）少数民族 PCa 幸存者的生活质量（QOL）。
在 MEDLINE、Cochrane 系统评价数据库、Cochrane 对照试验中心注册库、CINAHL 和 PsycINFO 中，使用前列腺癌、少数民族和干预措施的 MeSH 标题进行搜索。
我们确定了以美国为基础、以英语发表的（1985 年至 2010 年）关于改善 PCa IDM 和 QOL 的干预措施的文章，这些文章包括 50%或更多的少数民族患者，或按种族/族裔分层的分析。
使用 Downs 和 Black（DB）系统评估和评分文章（n=19）的质量。干预措施按以下方式组织：增强 1）关于 PCa 筛查的 IDM，2）改善 PCa 幸存者的 QOL 和症状。根据干预类型（教育研讨会、印刷材料、基于电话的、视频和基于网络的）报告结果。
14 项研究评估了增强 PCa 筛查 IDM 的干预措施，5 项研究评估了改善 PCa 幸存者结局的方案。在 13 项测量知识的筛查研究中，有 12 项知识评分统计学上显著增加，不同干预类型的效果范围不同：教育计划（增加 13%至 48%）、印刷（增加 11%至 18%）、录像带/ DVD（增加 16%）和基于网络的（增加 7%至 20%）。在最后一项筛查研究中，一项改善关于筛查的决策制定的干预措施使决策自我效能提高了 9%。五项认知行为干预措施通过增强问题解决和应对技能，改善了接受局部 PCa 治疗的少数民族男性的生活质量。
研究设计薄弱、样本量小、选择偏倚以及研究之间随访间隔的差异。
教育计划是改善筛查合格的少数民族男性知识的最有效干预措施。认知行为策略改善了接受局部 PCa 治疗的少数民族男性的生活质量。
