Men's experiences of deciding about treatment for localized prostate cancer: a meta-synthesis.

BACKGROUND: Prostate cancer is the most common cancer in men worldwide and nowadays several treatments are available, each presenting risks and benefits. Therefore, deciding on the most appropriate treatment is particularly challenging for men at the time of the diagnosis. AIM: This review was aimed at identifying, analyzing, and synthesizing the qualitative evidence on the experience of deciding about treatment after a diagnosis of localized Prostate cancer (LPC) METHODS: A meta-synthesis according to the meta-aggregation approach of the Joanna Briggs Institute (JBI) was used. The CINAHL, MEDLINE, and PsycINFO databases were searched for qualitative studies published from January 1998 to August 2018 in English and Italian. Qualita- tive Assessment and Review Instrument of JBI was used. RESULTS: From the identified sixteen studies two synthesized findings were derived that describe the decision-making as a complex process made in condition of emotional distress and influenced by internal and external factors; men evaluate differently the possible risks and benefits of cancer treatment, and after deciding they try to cope with their choice. CONCLUSION: The review provides evidence that men with LPC's need to receive emotional support and comprehensive information about the treatment options to facilitate their decision. The healthcare team should refer men to a multidisciplinary cancer service to permit access to all the treatment options.

Effectiveness of transitional care interventions in patients with serious illness and their caregivers: a systematic review protocol.

OBJECTIVE: The objective of this review is to evaluate the effectiveness of transitional care interventions for seriously ill patients and their caregivers. INTRODUCTION: Seriously ill patients and their caregivers may have complex health and social care needs that require services from numerous providers across multiple sectors. Transitional care interventions have been designed to enhance a collaborative approach among providers to facilitate the care transition process. However, the effectiveness of transitional care interventions for seriously ill patients and their caregivers, and the effects of such interventions on their outcomes, remain unclear. INCLUSION CRITERIA: Randomized controlled trials with adult patients (≥18 years old) with serious illness and their caregivers involved in transitional care programs will be considered for inclusion. The patients' outcomes will include mortality and/or survival, symptoms (eg, pain, nausea), and health-related quality of life. The caregivers' outcomes will include caregiver burden, preparedness, and well-being. METHODS: The JBI methodology for systematic reviews of effectiveness will be followed. The search strategy will aim to locate published and unpublished studies. Electronic databases, including PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, will be systematically searched from 2003 to the present. Studies in English, Italian, Spanish, French, and German will be included. Critical appraisal and data extraction will be conducted using standardized tools. Quantitative data will be pooled in statistical meta-analysis or, if statistical pooling is not possible, the findings will be reported narratively. Certainty of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022319848.