'They're doing surgery on two people': a meta-ethnography of the influences on couples' treatment decision making for prostate cancer

Background  Current orthodoxy suggests that patients need to be provided with full information about their care and that treatment options should be discussed with patients and family members. This imperative is especially challenging when there is a lack of consensus about treatment effectiveness and equivocacy over different types of interventions. In the case of prostate cancer, evidence is contested as to the efficacy of different treatments. Thus, involving patients and their family members in treatment choices is complex and little is known about how patients and their partners process these decisions when there is uncertainty about different outcomes. This paper has reviewed the literature on the way couples approach such decision making in relation to treatment for prostate cancer.

Objective  A meta-ethnographic synthesis of published qualitative papers that focused on the influences on patients’, and their partners’ treatment decision making for prostate cancer, was conducted in order to identify and understand barriers and facilitators which impact on this process.

Results  Our synthesis indicates that the couples’ relationship ‘dynamic’ provides a contextual background against which treatment decisions are negotiated and made.

Discussion and conclusions  We propose that the findings from this synthesis can enhance the potential for shared decision making for patients, and their partners, when facing a treatment decision for prostate cancer. By understanding the couples’ relationship dynamic pre-diagnosis, clinicians may be able to tailor the communication and information provision to both patients and their partners, providing a personalized approach to treatment decision making.