Accuracy of PSA Self-Reports among Low-Income Men with Prostate Cancer after a Public Health Nursing Intervention

Public Health Nurs. 2016 Nov;33(6):511-518. doi: 10.1111/phn.12270. Epub 2016 May 8.

Abstract

Objectives: To examine accuracy of patient-reported prostate-specific antigen (PSA) levels among indigent, uninsured men in a state-funded prostate cancer treatment program that provides case management, care coordination, and health education.

Design and sample: Program evaluation. About 114 men with matched self- and lab-reported PSA levels at program enrollment and another time point within 18 months.

Measures: Abstraction of self- and lab-reported PSA levels to determine self-report as "accurate" or "inaccurate," and evaluate accuracy change over time, before and after nursing interventions. Chi-square tests compared patients with accurate versus inaccurate PSA values. Nonlinear multivariate analyses explored trends in self-reported accuracy over time.

Intervention: Program enrollees receive prostate cancer education from a Nurse Case Manager (NCM), including significance of PSA levels. Men self-report PSA results to their NCM following lab draws and appointments. The NCM provides ongoing education about PSA levels.

Results: Of the sample, 46% (n = 53) accurately reported PSA levels. Accuracy of PSA self-reports improved with increasing time since program enrollment. Compared with men at public facilities, those treated at private facilities showed increasing accuracy in self-reported PSA (p = .038).

Conclusion: A targeted nursing intervention may increase specific knowledge of PSA levels. Additionally, the provider/treatment setting significantly impacts a patient's disease education and knowledge.

Keywords: cancer; health literacy; men's health; public health nursing practice; underserved populations.

MeSH terms

  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medically Uninsured
  • Middle Aged
  • Nursing Evaluation Research
  • Poverty
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / nursing*
  • Public Health Nursing*
  • Reproducibility of Results
  • Self Report*

Substances

  • Prostate-Specific Antigen