Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer: A qualitative research

Jie Cao; Chunxue Peng; Xiaoying Lu; Lingjun Zhou; Jing Wu

doi:10.1016/j.ajur.2021.08.003

Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer: A qualitative research

Asian J Urol. 2022 Apr;9(2):177-185. doi: 10.1016/j.ajur.2021.08.003. Epub 2021 Aug 27.

Authors

Jie Cao¹, Chunxue Peng¹, Xiaoying Lu², Lingjun Zhou³, Jing Wu³

Affiliations

¹ Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
² Department of Nursing, Changhai Hospital, Naval Medical University, Shanghai, China.
³ School of Nursing, Naval Medical University, Shanghai, China.

Abstract

Objective: There was increasingly demand of participation in surgical decision-making among Chinese patients with prostate cancer. However, due to the complex healthcare system and advanced care settings, it is quite challenging for the patients to gain sufficient support from the institute and the government. This research aimed to investigate the factors that impact the degree of participation in surgical decision-making among Chinese prostate cancer patients.

Methods: A phenomenological approach of qualitative research based on the results of semi-structured interviews was adopted, to explore the influencing factors which hinder the participation in surgical decision-making. Consolidated Criteria for Reporting Qualitative Research were utilized. Up to 160 post-operative patients who had undergone radical prostatectomy along with 68 medical and nursing staffs, were purposively recruited in this research. This retrospective study was carried out from September 2018 to August 2019. After recording and transcribing the interviews, the interview materials were evaluated via the Colaizzi's seven step approach and the NVivo Version 10 software to analyze the interview content.

Results: According to the analysis and summary of the interviews, there were three factors affecting the degree of participation in surgical decision-making. Firstly, insufficient information was provided by medical and nursing staffs because of their lack of time, proper communication skills, and career experience, as well as difficulties in the development of patient decision aid and inconsistent resource availability. Secondly, the cognitive level of decision-making among patients was relatively low due to poor psychological endurance, insufficient amount of education, senility, and less knowledge and information demand. Ultimately, decisions were constantly made by family members with/without patients.

Conclusions: The degree of participation of Chinese prostate cancer patients in the surgical decision-making had much space for improvement.

Keywords: Decision-making; Influence factors; Participation; Prostate cancer; Qualitative research; Surgery.