Testing the feasibility, acceptability and effectiveness of a ‘decision navigation’ intervention for early stage prostate cancer patients in Scotland – a randomised controlled trial

Belinda Hacking, Louise Margaret Wallace, Sarah Scott, Joanna Kosmala-Anderson, Jeffrey Belkora, Alan McNeill

    Research output: Contribution to journalArticle

    44 Citations (Scopus)

    Abstract

    Objective Does decision navigation (DN) increase prostate cancer patients' confidence and certainty in treatment decisions, while reducing regret associated with the decisions made? Methods Two hundred eighty-nine newly diagnosed prostate cancer patients were eligible. 123 consented and were randomised to usual care (n = 60) or navigation (n = 63). The intervention involved a ‘navigator’ guiding the patient in creating a personal question list for a consultation and providing a CD and typed summary of the consultation to patients, the general practitioner and physician. The primary outcome was decisional self efficacy. Secondary outcomes included decisional conflict (DCS) and decisional regret (RS). Measures of mood (Hospital Anxiety and Depression Scale) and adjustment (Mental Adjustment to Cancer Scale) were included to detect potential adverse effects of the intervention. Results ANOVA showed a main effect for the group (F = 7.161, df 1, p = 0.009). Post hoc comparisons showed significantly higher decisional self efficacy in the navigated patients post-consultation and 6 months later. Decisional conflict was lower for navigated patients initially (t = 2.005, df = 105, p = 0.047), not at follow-up (t = 1.969, df = 109, p = 0.052). Regret scores were significantly lower in the navigation group compared to the controls 6 months later (t = −2.130, df = 100, p = 0.036). There was no impact of the intervention on mood or adjustment. Conclusion Compared to control patients, navigated patients were more confident in making decisions about cancer treatment, were more certain they had made the right decision after the consultation and had less regret about their decision 6 months later. Decision navigation was feasible, acceptable and effective for newly diagnosed prostate cancer patients in Scotland.
    Original languageEnglish
    JournalPsycho-Oncology
    DOIs
    Publication statusPublished - 9 May 2012

    Fingerprint

    Scotland
    Prostatic Neoplasms
    Randomized Controlled Trials
    Social Adjustment
    Emotions
    Referral and Consultation
    Self Efficacy
    Patient Navigation
    General Practitioners
    Neoplasms
    Decision Making
    Anxiety
    Depression
    Physicians
    Therapeutics

    Bibliographical note

    This article has been published online ahead of being published in print therefore there is no volume or issue number at present.

    Keywords

    • cancer
    • oncology
    • prostate
    • decision aid
    • self efficacy

    Cite this

    Testing the feasibility, acceptability and effectiveness of a ‘decision navigation’ intervention for early stage prostate cancer patients in Scotland – a randomised controlled trial. / Hacking, Belinda; Wallace, Louise Margaret; Scott, Sarah; Kosmala-Anderson, Joanna; Belkora, Jeffrey; McNeill, Alan.

    In: Psycho-Oncology, 09.05.2012.

    Research output: Contribution to journalArticle

    Hacking, Belinda ; Wallace, Louise Margaret ; Scott, Sarah ; Kosmala-Anderson, Joanna ; Belkora, Jeffrey ; McNeill, Alan. / Testing the feasibility, acceptability and effectiveness of a ‘decision navigation’ intervention for early stage prostate cancer patients in Scotland – a randomised controlled trial. In: Psycho-Oncology. 2012.
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    abstract = "Objective Does decision navigation (DN) increase prostate cancer patients' confidence and certainty in treatment decisions, while reducing regret associated with the decisions made? Methods Two hundred eighty-nine newly diagnosed prostate cancer patients were eligible. 123 consented and were randomised to usual care (n = 60) or navigation (n = 63). The intervention involved a ‘navigator’ guiding the patient in creating a personal question list for a consultation and providing a CD and typed summary of the consultation to patients, the general practitioner and physician. The primary outcome was decisional self efficacy. Secondary outcomes included decisional conflict (DCS) and decisional regret (RS). Measures of mood (Hospital Anxiety and Depression Scale) and adjustment (Mental Adjustment to Cancer Scale) were included to detect potential adverse effects of the intervention. Results ANOVA showed a main effect for the group (F = 7.161, df 1, p = 0.009). Post hoc comparisons showed significantly higher decisional self efficacy in the navigated patients post-consultation and 6 months later. Decisional conflict was lower for navigated patients initially (t = 2.005, df = 105, p = 0.047), not at follow-up (t = 1.969, df = 109, p = 0.052). Regret scores were significantly lower in the navigation group compared to the controls 6 months later (t = −2.130, df = 100, p = 0.036). There was no impact of the intervention on mood or adjustment. Conclusion Compared to control patients, navigated patients were more confident in making decisions about cancer treatment, were more certain they had made the right decision after the consultation and had less regret about their decision 6 months later. Decision navigation was feasible, acceptable and effective for newly diagnosed prostate cancer patients in Scotland.",
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    AU - Hacking, Belinda

    AU - Wallace, Louise Margaret

    AU - Scott, Sarah

    AU - Kosmala-Anderson, Joanna

    AU - Belkora, Jeffrey

    AU - McNeill, Alan

    N1 - This article has been published online ahead of being published in print therefore there is no volume or issue number at present.

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    N2 - Objective Does decision navigation (DN) increase prostate cancer patients' confidence and certainty in treatment decisions, while reducing regret associated with the decisions made? Methods Two hundred eighty-nine newly diagnosed prostate cancer patients were eligible. 123 consented and were randomised to usual care (n = 60) or navigation (n = 63). The intervention involved a ‘navigator’ guiding the patient in creating a personal question list for a consultation and providing a CD and typed summary of the consultation to patients, the general practitioner and physician. The primary outcome was decisional self efficacy. Secondary outcomes included decisional conflict (DCS) and decisional regret (RS). Measures of mood (Hospital Anxiety and Depression Scale) and adjustment (Mental Adjustment to Cancer Scale) were included to detect potential adverse effects of the intervention. Results ANOVA showed a main effect for the group (F = 7.161, df 1, p = 0.009). Post hoc comparisons showed significantly higher decisional self efficacy in the navigated patients post-consultation and 6 months later. Decisional conflict was lower for navigated patients initially (t = 2.005, df = 105, p = 0.047), not at follow-up (t = 1.969, df = 109, p = 0.052). Regret scores were significantly lower in the navigation group compared to the controls 6 months later (t = −2.130, df = 100, p = 0.036). There was no impact of the intervention on mood or adjustment. Conclusion Compared to control patients, navigated patients were more confident in making decisions about cancer treatment, were more certain they had made the right decision after the consultation and had less regret about their decision 6 months later. Decision navigation was feasible, acceptable and effective for newly diagnosed prostate cancer patients in Scotland.

    AB - Objective Does decision navigation (DN) increase prostate cancer patients' confidence and certainty in treatment decisions, while reducing regret associated with the decisions made? Methods Two hundred eighty-nine newly diagnosed prostate cancer patients were eligible. 123 consented and were randomised to usual care (n = 60) or navigation (n = 63). The intervention involved a ‘navigator’ guiding the patient in creating a personal question list for a consultation and providing a CD and typed summary of the consultation to patients, the general practitioner and physician. The primary outcome was decisional self efficacy. Secondary outcomes included decisional conflict (DCS) and decisional regret (RS). Measures of mood (Hospital Anxiety and Depression Scale) and adjustment (Mental Adjustment to Cancer Scale) were included to detect potential adverse effects of the intervention. Results ANOVA showed a main effect for the group (F = 7.161, df 1, p = 0.009). Post hoc comparisons showed significantly higher decisional self efficacy in the navigated patients post-consultation and 6 months later. Decisional conflict was lower for navigated patients initially (t = 2.005, df = 105, p = 0.047), not at follow-up (t = 1.969, df = 109, p = 0.052). Regret scores were significantly lower in the navigation group compared to the controls 6 months later (t = −2.130, df = 100, p = 0.036). There was no impact of the intervention on mood or adjustment. Conclusion Compared to control patients, navigated patients were more confident in making decisions about cancer treatment, were more certain they had made the right decision after the consultation and had less regret about their decision 6 months later. Decision navigation was feasible, acceptable and effective for newly diagnosed prostate cancer patients in Scotland.

    KW - cancer

    KW - oncology

    KW - prostate

    KW - decision aid

    KW - self efficacy

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    JO - Psycho-Oncology

    JF - Psycho-Oncology

    SN - 1057-9249

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