ABSTRACT
BACKGROUND: Due to the multitude of therapy options, the treatment decision after diagnosis of localized prostate cancer is challenging. Compared to printed booklets, web-based information technology offers more possibilities to tailor information to patients' individual needs. OBJECTIVES: To support the decision-making process as well as the communication with patients, we developed an online tutorial in a systematic process in the German-speaking part of Switzerland and then tested it in a pilot study. The study investigated users' satisfaction, the coverage of information needs, the preparation for decision making, and the subjective quality of the decision. MATERIALS AND METHODS: Based on already existing information material, the online tutorial was developed in an iterative process using focus groups with patients and urologists. For the following evaluation in eight clinics a total of 87 patients were invited to access the platform and participate in the study. Of these patients, 56 used the tutorial and 48 answered both surveys (the first one 4 weeks after the first login and the second one 3 months after treatment decision). The surveys used the Preparation for Decision Making Scale (PDMS), the Decisional Conflict Scale (DCS), and the Decisional Regret Scale (DRS). RESULTS AND CONCLUSION: Satisfaction with the tutorial is very high among patients with newly diagnosed localized prostate cancer. Users find their information needs sufficiently covered. Three months after the decision they felt that they were well prepared for the decision making (mean PDMS 75, standard deviation [SD] 23), they had low decisional conflict (mean DCS 9.6, SD 11), and almost no decisional regret (mean DRS 6.4, SD 9.6). Based on these findings, further use of the tutorial can be recommended.
Subject(s)
Decision Making , Patient Education as Topic/methods , Patient Participation , Prostatic Neoplasms/therapy , Telemedicine , Communication , Decision Support Techniques , Humans , Male , Pilot Projects , Prostatic Neoplasms/diagnosis , SwitzerlandABSTRACT
BACKGROUND: In the context of shared decision-making it is important to know more about information needs of prostate cancer patients. Therefore, this study investigates content and extent of these information needs. MATERIAL AND METHODS: We surveyed 330 patients of 4 urological Clinics in Switzerland with a well-established written questionnaire between 3 and 24 months after their diagnosis of an early-stage prostate cancer. A total of 179 patients responded and 128 (39%) questionnaires were entered into final statistical analysis. RESULTS: Patients expressed broad information needs and pronounced differences between individuals were observed. Each of the 92 questions presented was rated as "essential" by at least 18% of the patients. On average 50 questions were rated as 'essential'. One patient rated only four questions as 'essential' whereas another participant reported all 92 questions as being 'essential' to him. CONCLUSIONS: Concerning patient education it is important to identify the individual information needs of each prostate cancer patient separately.
Subject(s)
Health Services Needs and Demand , Individuality , Patient Education as Topic , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/psychology , Aged , Aged, 80 and over , Decision Making , Humans , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Prostatic Neoplasms/pathology , Surveys and Questionnaires , SwitzerlandABSTRACT
Until the 1980s, treatment of upper urinary tract often involved extensive surgical procedures. With the introduction of the extracorporeal shock-wave lithotripsy and refinements to endoscopic instruments and surgical techniques, it has now become possible to destroy stones in most cases without open surgery. Modern stone management can be divided into three steps. The first step covers the treatment of acute pain and the drainage of an obstructed and possibly infected kidney. The second step aims to either remove for destroy the stone. The third step is directed towards the prophylaxis of stone recurrence.
Subject(s)
Urinary Calculi/therapy , Humans , Lithotripsy , UreteroscopyABSTRACT
Disorders of libido, erection orgasm and ejaculation are the most important reasons for male sexual dysfunction (MSD), because of organic reasons, medical therapies and social stressing factors, MSD is increasingly evaluated more precisely and it is not limited on erectile dysfunction any longer. With the appearance of the first oral acting substance on the market and the presence of media a great pressure arose to the medical doctors to do prescriptions. Therefore, it is very important to have consultation, diagnostics and treatment of the MSD done with elaborated medical criteria.