Supporting Patients in Making Treatment Decisions for Early Prostate Cancer: A Qualitative Study of Healthcare Professionals’ Views on Barriers and Challenges in an Asian Country
1Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
2Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
3Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
4Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
DOI: 10.31083/jomh.v12i1.21 Vol.12,Issue 1,January 2016 pp.18-24
Published: 04 January 2016
Background: The aim of this study is to explore the challenges faced by healthcare professionals (HCPs) in Malaysia in supporting patients with early prostate cancer in making treatment decisions.
Methods: Four in-depth individual interviews and three focus group discussions were conducted with urologists (n=11), urology trainees (n=5), oncologists (n=3) and policy makers (n=1) in Malaysia in 2012-2013. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyze the data.
Results: Challenges reported by HCPs in supporting patients in making decisions about prostate cancer treatment consisted of patient, social, healthcare professionals and health system factors. Patient-related challenges were: distrust of HCPs, difficulty in communicating information, preconceptions, attitudes to treatment, preparedness for decision making, viewing prostate cancer as taboo and fear of treatment complications, or side-effects. Social factors, such as influence of family or others, also posed a problem for HCPs seeking to support patients’ decision-making. HCP-related challenges included: differences of opinion among HCPs, uncertainty about the best treatment option and lack of interdisciplinary cooperation. Healthcare system factors challenges included: lack of support staff, time constraints, treatment availability and treatment costs. HCPs suggested that delivery of care by multi-disciplinary teams, and more use of audio-visual media, would help patients to make decisions. Conclusions: HCPs faced various challenges in supporting patients with prostate cancer in making decisions about treatment. Delivery of care by a supportive team in a specialist centre may improve the support patients receive in making decisions.
Cancer, decision, prostate, support, treatment
Ping Yein Lee,Ai Theng Cheong,Chirk Jenn Ng,Yew Kong Lee,Khatijah Lim Abdullah,Azad Hassan Abdul Razack,Teng Aik Ong. Supporting Patients in Making Treatment Decisions for Early Prostate Cancer: A Qualitative Study of Healthcare Professionals’ Views on Barriers and Challenges in an Asian Country. Journal of Men's Health. 2016. 12(1);18-24.
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