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A Decision Aid to Support Informed Choices for Patients Recently Diagnosed With Prostate Cancer: A Randomized Controlled Trial

Chabrera, Carolina MSN, RN; Zabalegui, Adelaida PhD, RN, FEANS; Bonet, Marta PhD; Caro, Mónica MD; Areal, Joan PhD; González, Juan R PhD; Font, Albert PhD

doi: 10.1097/NCC.0000000000000170
Articles: Online Only

Background: Decision aids provide balanced information about the benefits and risks of treatment options and improve the match between patient preferences and the treatment received.

Objective: To assess the impact of a decision aid regarding the treatment options for patients with localized prostate cancer.

Methods: A 2-arm randomized controlled trial was used to compare booklet patient decision aid (intervention group n = 61) with standard information for localized prostate cancer (control group n = 61). The study was conducted at 3 hospitals between 2011 and 2013. The main outcome measures were knowledge, decisional conflict, satisfaction with the decision-making process, and coping.

Results: The respective mean Decisional Conflict Scale scores before and after the intervention were 53.0 ± 16.9 and 31.2 ± 10.2 in the intervention group and 49.1 ± 13.7 and 51.7 ± 13.3 in the control group (P < .001). Mean Knowledge scores were 38.6 ± 16.5 and 75.7 ± 19.0 in the intervention group and 42.0 ± 17.6 and 49.9 ± 16.0 in the control group (P < .001). Mean Satisfaction With Decision Scale scores were 81.1 ± 8.92 and 95.7 ± 6.89 in the intervention group and 82.5 ± 12.0 and 79.3 ± 10.3 in the control group (P < .001).

Conclusions: Decision aid not only improved patient knowledge about localized prostate cancer and its treatment and their satisfaction with decision making but also decreased their decisional conflict.

Implications for Practice: Decision aid represents a rather innovative approach for a health insurance fund to develop and offer this format of information and decision support. This opens a new field of study for nurses to empower patients in the decision-making process and develop new roles in this area.

Author Affiliations: School of Health Science–TecnoCampus, Department of Nursing, University Pompeu Fabra, Mataró (Ms Chabrera); Departments of Oncology (Ms Chabrera and Dr Font) and Radiation Oncology (Dr Caro), Catalan Institute of Oncology, Badalona; Hospital Clinic, Barcelona (Dr Zabalegui); Oncology Institute of Vallés, Terrassa (Dr Bonet); Department of Urology, University Hospital Germans Trias i Pujol, Badalona (Dr Areal); and Center for Research in Environmental Epidemiology–CREAL, Barcelona (Dr González), Spain.

This project was supported by the Official Nursing College of Barcelona and the Badalona Against Cancer Foundation.

The authors have no conflicts of interest to disclose.

Correspondence: Carolina Chabrera, MSN, RN, School of Health Science, Department of Nursing, TecnoCampus, Avinguda Ernest Lluch, 32, 08302, Mataró, Spain (

Accepted for publication January 4, 2013.

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