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Date of Award

12-8-2021

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Thesis Committee Chairperson

Janice Hobba-Glose, DNS, MSN, RN

Second Reader

Patricia Losito, DNP, RN

Keywords

prostate cancer, PSA testing, protective service occupations, shared decision making, informed decision making

Abstract

Clinical Problem: Prostate cancer is the most common cancer among men in the United States and is the leading cause of death (CDC, 2021). Etiology of prostate cancer remains unclear but in recent research it has been shown that there is an association between occupation and prostate cancer risk (Sritharan, et al., 2019). Specifically protective service occupations including firefighters, policeman and detectives, guards, and watchmen (Sritharan et al., 2019).

Significance: With new evidence of risk factors, it is important that these individuals understand that they are at an increased risk of being diagnosed with prostate cancer. In 2018, New York State reported 15,714 cases of prostate cancer. With such a high incidence it is important that these individuals are participating in secondary prevention measures in the hopes that prostate cancer is caught early.

PICOT Question: This EBP proposal is framed around the following PICOT question: Among persons who are in protective service occupations, what is the impact of a Nurse Practitioner led shared decision coaching program that utilizes a decision aid on improved knowledge of prostate cancer, confidence in shared decision making for prostate cancer screening and patient satisfaction over 12 weeks?

Clinical Change: The change that will be implemented in this proposal is a nurse practitioner led shared decision coaching that will occur in a primary care setting with participants in protective service occupations. Education will be provided during the decision coaching and an opportunity to ask questions about prostate cancer and an individual’s specific risk factors will be allotted. Following the decision coaching the patient will be given the choice to have a PSA test ordered for them and if they decide to follow through with PSA testing, the nursing staff with take their blood draw then.

Desired Outcome: The desired outcome of this evidence-based proposal will include improved knowledge of prostate cancer specifically anatomy and function, risk factors, screening, and symptoms of prostate cancer. Other outcomes include increase in PSA testing with improved confidence in decision making regarding the testing and improved satisfaction with the interaction between the patient and nurse practitioner.

Summary: Through a review and synthesis of the literature, it was determined that the use of decision coaching and the use of decision aids are effective interventions for improving knowledge, satisfaction, and confidence.

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