Short summary

The object of the study is to explore the communicative processes between patients with advanced prostate cancer and health professionals regarding treatment-related decision-making, health professionals' and patients' approach to patient involvement, and organizational possibilities and. Data is collected using participant observations in a urological outpatient clinic. Furthermore, qualitative interviews of 15 patients with advanced prostate cancer and health professionals involved in the treatment of the patients are conducted. Paul Ricoeur's theory of interpretation is used to interpret the data.

Rationale

Introduction & objectives 

The benefits of involving patients in decision-making for increasing patient safety, health, and compliance are well documented. And as a method to promote patient involvement, shared decision-making is an acknowledged method. However, it is argued that the approach is complex and time-consuming requiring specific communication skills training of the health professionals. It has also been found that the way the healthcare system is organized may work as either barriers to or facilitators of shared decision-making. Studies have shown that many patients prefer shared decision-making with their physician. Still, there is a difference to which degree patients wish to be part of decision-making. Some patients find it difficult or feel insecure deciding on treatment, and prefer the doctor to decide on their behalf. In the treatment of advanced prostate cancer, it is often narrowed down to a choice between different types of hormone deprivation therapies, all associated with unpleasant physical and psychological adverse events, or no treatment at all. For some patients, it is furthermore a choice between early chemo-therapy or not. When making such treatment-related decisions, it is essential to involve the patients' preferences, needs, and desires. Research related to decision-making and the influence of organizational factors on patient involvement in relation to this patient group is limited.

The objective of the study

The object of the study is to explore the communicative processes between patients with advanced prostate cancer and health professionals regarding treatment-related decision-making; and to investigate health professionals' and patients' approach to patient involvement.

Description of the cohort

Men with advanced prostate cancer.

Data and biological material

Individual qualitative interviews. Field notes.

Collaborating researchers and departments

Urological Research Center, Institute of Regional Health Research, Lillebaelt Hospital, University of Southern Denmark 

• Professor Palle Jörn Sloth Osther

Department for Health Services Research, Institute of Regional Health Research, Lillebaelt Hospital, University of Southern Denmark

• Professor Jette Ammentorp
• Professor Regner Birkelund