Prostate cancer patients' experience of involvement in decision-making: a phenomenological hermeneutic study

Background: Shared decision-making (SDM) is a process increasingly recommended as a mean of involving patients in their care. Research shows, however, that it is infrequently employed in everyday clinical practice. Only limited research has been carried out concerning prostate cancer patients’ experiences of being involved in the course of their disease and whether they experience being informed in a relevant way. In Denmark this area remains under investigated. Patient satisfaction, treatment results and patient safety can be improved if patients are involved in decision-making concerning the course of their disease. Studies have shown that many prostate cancer patients prefer to engage in SDM with their doctor. Aim: We aimed to examine prostate cancer patients' experience of becoming involved in decision-making concerning the course of their disease, as well as to examine whether they felt sufficiently informed.
Method: This study is based on qualitative semi-structured life-world interviews of 6 prostate cancer patients. The interviews were carried out in the participants’ homes during March and April 2014. The interpretation of the data is based on Paul Ricoeur’s phenomenological-hermeneutic theory of interpretation.
Results: Through analysis and interpretation of the data, two themes were identified: (1) Following the procedure (2) Like being a parcel at the mail distribution centre. The patients experienced being sent through a standard procedure with a one- sided focus on examinations and treatment issues. Recurring themes in the patients’ narratives were insufficient communication, objectification and lack of involvement in decisions concerning their disease and treatment.
Conclusion: It is concluded that most patients do not become involved in decision-making and do not feel sufficiently informed. This observation has direct implications for the extent to which care provision is person-centered.