Primary goals, information-giving and men’s understanding

a qualitative study of Australian and UK doctors’ varied communication about PSA screening

Kristen Pickles, Stacy Carter, Lucie Rychetnik, Kirsten Mccaffery, Vikki Entwistle

Research output: Contribution to journalArticle

1 Citation (Scopus)
4 Downloads (Pure)

Abstract

Objectives (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary.

Study design and setting A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29).

Results GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach.

Conclusion GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardised in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions.
Original languageEnglish
Article numbere018009
JournalBMJ Open
Volume8
Issue number1
Early online date23 Jan 2018
DOIs
Publication statusPublished - Jan 2018

Fingerprint

Prostate-Specific Antigen
General Practitioners
Communication
Early Detection of Cancer
Prostatic Neoplasms
Primary Health Care

Cite this

Primary goals, information-giving and men’s understanding : a qualitative study of Australian and UK doctors’ varied communication about PSA screening . / Pickles, Kristen; Carter, Stacy; Rychetnik, Lucie; Mccaffery, Kirsten; Entwistle, Vikki.

In: BMJ Open, Vol. 8, No. 1, e018009, 01.2018.

Research output: Contribution to journalArticle

Pickles, Kristen ; Carter, Stacy ; Rychetnik, Lucie ; Mccaffery, Kirsten ; Entwistle, Vikki. / Primary goals, information-giving and men’s understanding : a qualitative study of Australian and UK doctors’ varied communication about PSA screening . In: BMJ Open. 2018 ; Vol. 8, No. 1.
@article{350a2725db624fe8851ae7a89e31bb07,
title = "Primary goals, information-giving and men’s understanding: a qualitative study of Australian and UK doctors’ varied communication about PSA screening",
abstract = "Objectives (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary.Study design and setting A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29).Results GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach.Conclusion GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardised in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions.",
author = "Kristen Pickles and Stacy Carter and Lucie Rychetnik and Kirsten Mccaffery and Vikki Entwistle",
note = "The work was supported by Australia’s National Health and Medical Research Council (NHMRC) grant 1023197. SC reports grants from National Health and Medical Research Council Grant 1023197, 1032963; LR reports grant from National Health and Medical Research Council Grant 1023197 during the conduct of the study.",
year = "2018",
month = "1",
doi = "10.1136/bmjopen-2017-018009",
language = "English",
volume = "8",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Primary goals, information-giving and men’s understanding

T2 - a qualitative study of Australian and UK doctors’ varied communication about PSA screening

AU - Pickles, Kristen

AU - Carter, Stacy

AU - Rychetnik, Lucie

AU - Mccaffery, Kirsten

AU - Entwistle, Vikki

N1 - The work was supported by Australia’s National Health and Medical Research Council (NHMRC) grant 1023197. SC reports grants from National Health and Medical Research Council Grant 1023197, 1032963; LR reports grant from National Health and Medical Research Council Grant 1023197 during the conduct of the study.

PY - 2018/1

Y1 - 2018/1

N2 - Objectives (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary.Study design and setting A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29).Results GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach.Conclusion GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardised in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions.

AB - Objectives (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary.Study design and setting A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29).Results GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach.Conclusion GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardised in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions.

U2 - 10.1136/bmjopen-2017-018009

DO - 10.1136/bmjopen-2017-018009

M3 - Article

VL - 8

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 1

M1 - e018009

ER -