Informed decision-making based on a leaflet in the context of prostate cancer screening.
Tessa Dierks, Eveline A M Heijnsdijk, Ida J Korfage and 2 others
PMID 31014933WHAT IT FOUND
Men who read a prostate cancer screening leaflet had better knowledge and more often made an informed choice than men who did not read it.
Attitude and intention to screen did not differ.
Key findings
01A significantly higher proportion of men who read the leaflet had sufficient knowledge than men who did not read it (96% vs 67%, p<0.001).
02Informed choice was significantly higher among men who read the leaflet (73%) than among men who did not read it (62%, p=0.001).
03There was no significant difference in attitude or intended screening uptake between men who read the leaflet and those who did not.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was hypothetical because no population-based prostate cancer screening programme exists in the Netherlands, so it did not measure actual screening participation. Men were not randomly assigned to read or not read the leaflet; groups were formed after responses, and men who read the leaflet had a higher educational level. The knowledge measure had no psychometric evaluation, and sufficient knowledge was defined as eight or more correct answers out of 13. The questionnaire was completed once, so the researchers could not know knowledge or attitude before reading the leaflet. Reading status was based on self-report and one minute of page time, so some men may have been classified incorrectly. Highly educated men were overrepresented: 47% of all respondents had a high educational level, and 53% of men who read the leaflet had a high educational level, compared with about 30% of Dutch men aged 45 to 65. Some men who did not read the leaflet for longer than one minute said the leaflet was unclear.
The easy way to misread this
Do not conclude that the leaflet caused better informed decision-making. Men were not randomly assigned to read or not read the leaflet, and the more educated men were more likely to read it. The study also used a hypothetical invitation, not actual prostate cancer screening.