Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Patient Educ Couns. 2013 Jan;90(1):61-8. doi: 10.1016/j.pec.2012.08.007. Epub 2012 Aug 31.
To examine African-American prostate cancer (PCa) survivors' involvement in treatment decision-making (TDM), and examine the association between TDM and quality of life (QOL), using secondary data.
African-American PCa survivors (181) were recruited from the North Carolina Central Cancer Registry. Participants completed a cross-sectional survey that asked about their chosen cancer treatment, TDM factors, and PCa-specific QOL (using the Expanded Prostate Cancer Index Composite--EPIC). Multivariate analysis of covariance was conducted to determine the association between TDM and QOL, controlling for confounders.
Most men reported being active (44.2%) or collaborative (38.1%) in TDM, while 14.4% preferred a passive role. Adjusting for marital status, education and treatment, passive patients reported somewhat better QOL compared to active patients in the following QOL domains: urinary summary (p=0.04), urinary function (p=0.01), and urinary incontinence (p=0.03).
Most African-American PCa survivors preferred to be, and were, actively or collaboratively involved in TDM. However, those who preferred a passive role reported better PCa-specific QOL for the urinary domain compared to others.
It is important to assess patients' TDM preference. Patients' QOL may differ by their TDM role, such that active patients may be more bothered by treatment side effects than other patients.
利用二次数据，考察非裔美国前列腺癌（PCa）幸存者在治疗决策（TDM）中的参与情况，并探讨 TDM 与生活质量（QOL）之间的关系。
从北卡罗来纳中央癌症登记处招募了 181 名非裔美国 PCa 幸存者。参与者完成了一项横断面调查，内容包括他们选择的癌症治疗、TDM 因素以及特定于 PCa 的 QOL（使用扩展前列腺癌指数综合量表--EPIC）。采用协方差的多元分析来确定 TDM 和 QOL 之间的关联，同时控制混杂因素。
大多数男性报告在 TDM 中表现积极（44.2%）或合作（38.1%），而 14.4%的男性则倾向于被动角色。在调整婚姻状况、教育程度和治疗方法后，与积极患者相比，被动患者在以下 QOL 领域报告了稍好的 QOL：尿总体状况（p=0.04）、尿功能（p=0.01）和尿失禁（p=0.03）。
大多数非裔美国 PCa 幸存者更喜欢并积极或合作地参与 TDM。然而，那些倾向于被动角色的患者在与尿相关的特定于 PCa 的 QOL 方面报告了更好的结果，与其他患者相比。
评估患者的 TDM 偏好非常重要。患者的 QOL 可能因 TDM 角色而异，例如，积极参与 TDM 的患者可能会比其他患者更受治疗副作用的困扰。
