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退伍军人对前列腺癌标准决策辅助工具与以患者为中心的决策辅助工具的反应中的种族差异:对非裔美国人和白人男性决策的影响。

Racial differences in veterans' response to a standard vs. patient-centered decision aid for prostate cancer: Implications for decision making in African American and White men.

作者信息

Langford Aisha T, Scherer Laura D, Ubel Peter A, Holmes-Rovner Margaret, Scherr Karen A, Fagerlin Angela

机构信息

Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Clinical and Translational Science Institute, New York University Grossman School of Medicine, New York, NY, USA.

Division of Cardiology, University of Colorado School of Medicine, Denver, CO, USA; Colorado Program for Patient Centered Decisions at ACCORDS, University of Colorado School of Medicine, Denver, CO, USA.

出版信息

Patient Educ Couns. 2020 Jun 3. doi: 10.1016/j.pec.2020.06.004.

Abstract

OBJECTIVE

To determine whether racial differences exist in patient preferences for prostate cancer treatment after being informed about options using a patient-centered vs. a standard decision aid (DA).

METHODS

This article reports secondary analyses of a large study of men diagnosed with early stage prostate cancer. Men were recruited from 4 VA Health Systems and randomized to receive a patient-centered or standard DA about prostate cancer treatment options. Data were collected at 1) baseline, 2) after reading the DA but prior to diagnosis, and 3) after receiving a cancer diagnosis and meeting with a urologist.

RESULTS

White patients who received the patient-centered DA written at a 7 grade reading level were more likely to prefer active surveillance and less likely to prefer radiation compared to those who received the standard DA written at >9th grade reading level. African American patients' treatment preferences did not differ as a function of DA.

CONCLUSIONS

When informed about prostate cancer treatment options through a patient-centered DA, White patients changed their treatment preferences but African American patients did not.

PRACTICE IMPLICATIONS

As DAs are increasingly being used in clinical practice, more research is needed regarding the efficacy, relevance, and receptivity of DAs for African Americans.

摘要

目的

在使用以患者为中心的决策辅助工具(DA)与标准决策辅助工具向患者告知前列腺癌治疗方案后,确定患者偏好是否存在种族差异。

方法

本文报告了一项针对被诊断为早期前列腺癌男性的大型研究的二次分析。男性患者从4个退伍军人健康系统招募,并随机接受关于前列腺癌治疗方案的以患者为中心的或标准的决策辅助工具。在以下三个时间点收集数据:1)基线时;2)阅读决策辅助工具后但在诊断前;3)接受癌症诊断并与泌尿科医生会诊后。

结果

与接受九年级以上阅读水平编写的标准决策辅助工具的患者相比,接受七年级阅读水平编写的以患者为中心的决策辅助工具的白人患者更倾向于主动监测,而不太倾向于放疗。非裔美国患者的治疗偏好不因决策辅助工具而有所不同。

结论

当通过以患者为中心的决策辅助工具了解前列腺癌治疗方案时,白人患者改变了他们的治疗偏好,而非裔美国患者则没有。

实践意义

随着决策辅助工具在临床实践中越来越多地被使用,需要更多关于决策辅助工具对非裔美国人的疗效、相关性和接受度的研究。

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