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 Wallace, Sarah Scott, Joanna Kosmala-Anderson, Jeff Belkora, Alan McNeill

Research output: Contribution to journalArticle

46 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
Pages (from-to)1017-1024
Number of pages8
JournalPsycho-Oncology
Volume22
Issue number5
Early online date9 May 2012
DOIs
Publication statusPublished - May 2013

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

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 ; Scott, Sarah; Kosmala-Anderson, Joanna; Belkora, Jeff; McNeill, Alan.

In: Psycho-Oncology, Vol. 22, No. 5, 05.2013, p. 1017-1024.

Research output: Contribution to journalArticle

Hacking, Belinda ; Wallace, Louise ; Scott, Sarah ; Kosmala-Anderson, Joanna ; Belkora, Jeff ; 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. 2013 ; Vol. 22, No. 5. pp. 1017-1024.
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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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note = "Acknowledgements We are grateful to Macmillan Cancer Support for their generous support and to numerous colleagues and patients. Macmillan Cancer Support funded this study in its entirety. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The trial is registered with NHS Lothian. Project ID Number: 2008/W/ON/26.",
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T1 - Testing the feasibility, acceptability and effectiveness of a ‘decision navigation’ intervention for early stage prostate cancer patients in Scotland

T2 - a randomised controlled trial

AU - Hacking, Belinda

AU - Wallace, Louise

AU - Scott, Sarah

AU - Kosmala-Anderson, Joanna

AU - Belkora, Jeff

AU - McNeill, Alan

N1 - Acknowledgements We are grateful to Macmillan Cancer Support for their generous support and to numerous colleagues and patients. Macmillan Cancer Support funded this study in its entirety. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The trial is registered with NHS Lothian. Project ID Number: 2008/W/ON/26.

PY - 2013/5

Y1 - 2013/5

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

U2 - 10.1002/pon.3093

DO - 10.1002/pon.3093

M3 - Article

VL - 22

SP - 1017

EP - 1024

JO - Psycho-Oncology

JF - Psycho-Oncology

SN - 1057-9249

IS - 5

ER -