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Annals of Family Medicine 5:112-119 (2007)
© 2007 Annals of Family Medicine, Inc.
doi: 10.1370/afm.623
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Patient Education on Prostate Cancer Screening and Involvement in Decision Making

Alex H. Krist, MD, MPH1, Steven H. Woolf, MD, MPH2, Robert E. Johnson, PhD3 and J. William Kerns, MD4

1 Department of Family Medicine, Fairfax Family Practice Residency, Virginia Commonwealth University, Fairfax, Va
2 Departments of Family Medicine, Epidemiology, and Community Health, Virginia Commonwealth University, Fairfax, Va
3 Departments of Family Medicine and Biostatistics, Virginia Commonwealth University, Fairfax, Va
4 Department of Family Medicine, Shenandoah Valley Family Practice Residency Program, Virginia Commonwealth University, Fairfax, Va


Figure 1
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  		Figure 1. Flowchart of study patients.

Note: Numbers of patients exclused do not add up to 576 because patients could have more than 1 reason for exclusion, ie, have blood work before examination and decline.

 

Figure 2
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  		Figure 2. Locus of decision-making control (N = 431).

Note: The figure shows patient-reported decision-making control by study group. A smaller percentage of control patients reported being in control of their decision making than did Web site patients (P1 = .03) or brochure patients (P2 = .03) when responding to the question, "How was the decision made today on whether to do a PSA blood test? (A) I made the decision on whether to order a PSA test. (B) I made the decision about whether to order a PSA test after seriously considering my doctor’s opinion. (C) My doctor and I shared the responsibility for deciding whether to order a PSA test. (D) My doctor made the final decision about whether to order a PSA test after seriously considering my opinion. (E) My doctor made the decision whether to order a PSA test." Previsit education did not increase the frequency of a shared locus of decision-making control (choice C).

 

Figure 3
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  		Figure 3. Patients’ actual and desired locus of decision-making control (N = 431).

Note: The figure shows the level of concordance between the locus of decision-making control that patients reported and the locus of control that they desired. Concordance did not differ between the 3 study groups (P1 = .41). Participants overall were more likely to report "More patient control than desired" than "More physician control than desired," however (19% vs 11%, P2 = .003).

 




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