The shared clinical decision regarding the risks of prostate cancer screening

• Autor(a) principal: Santos, Renata Oliveira Maciel dos
• Data de Publicação: 2021
• Outros Autores: Mendes de Abreu , Mirhelen, Montenegro Engstrom , Elyne
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/2470
• topic: Neoplasias da Próstata; Comunicação em Saúde; Tomada de Decisão Compartilhada; Prevenção Quaternária.; Prostatic Neoplasms; Health Communication; Decision Making, Shared; Quaternary Prevention.; Neoplasias de la Próstata; Comunicación en Salud; Toma de Decisiones Conjunta; Prevención Cuaternaria.

Introduction: Current evidence shows an imbalance between benefits and harms with the prostate cancer screening, which can cause considerable risks to men’s health. This statement supports the recommendation of the Brazilian Health Ministry that recommends not to stimulate this practice and large discussion about the implications of these exams when the man requests it. Purpose: Analyze the perception and experience of men and doctors about sharing the decision in screening for prostate cancer. Method: A qualitative and exploratory study was carried out, from a focus group with men of mature age (average: 51 years) and semi-structured interviews with doctors in basic health units, from different states in Brazil. The data were systematized, grouped, and categorized by content analysis. Results: Men were unaware of the possible damages related to the prostate cancer screening, and we also identified personal, cultural barriers and the organization of work’s process, that showed to difficult clinical communication during consultation in primary health care. On the other hand, men report a desire for greater participation in the choices about their health, mentioning the internet as a tool used to reduce the knowledge gap in the clinical relationship. The findings also present strategies used by doctors, such as infographic and tools, which help to include different profiles of men in decision making. Conclusion: The investigation demonstrated that, although there are advances in relation to the debate about possible harmful implications of prostate cancer screening and examples of inclusive approaches, this practice is not consolidated in Brazil, revealing the need to disseminate actions that encourage the participation in the decisions that directly influence their quality of life and well-being. Thus, there is a need to invest in strategies that facilitate doctor/patient communication, in addition to expanding the debate on the implications of screening among professionals inserted in Primary Health care and in the population.