在转移性前列腺癌（mPC）的决策中，共同决策（SDM）让患者参与决策过程，相对于医生或患者导向的决策，可能会带来更好的结果。我们评估了决策控制程度（DLOC）与mPC患者报告的生活质量（QOL）、功能性结果和决策满意度之间的关联。在进行治疗决策的门诊访问后（基线），mPC患者完成了DLOC和QOL调查。在基线后的2个和4个月，重新评估了QOL。使用混合效应模型，比较了每个QOL维度（身体、情感、认知、社交、角色功能）的平均分数在DLOC组之间的差异。通过调查同样收集了患者喜好的DLOC和提供者的沟通技巧。参与者（N=101）的中位年龄为69岁（范围：49-92岁）；大多数为白种人（80%）和已婚者（82%）。62%报告使用了SDM。在基线时，DLOC组之间的QOL维度没有差异。在4个月时，相较于医生导向的决策制定，患者导向（p = 0.01）和SDM（p = 0.03）与更好的身体功能相关。并有迹象表明，那些报告进行患者导向（p = 0.06）或SDM（p = 0.10）的患者可能会对决策感到更满意。SDM是最常见的DLOC。报告使用SDM的mPC患者在4个月时的身体功能更好，这表明患者参与决策可以带来可量化的好处。未来对更大、更多样化人群中这些关联的调查可以进一步阐明患者参与治疗决策的这些先前未测量的好处。 © 2023作者，独家授权Springer Nature Limited。

Shared decision-making (SDM) for metastatic prostate cancer (mPC) engages patients in the decision-making process and may be associated with better outcomes relative to physician- or patient-directed decision-making. We assessed the association between decision locus of control (DLOC) and patient-reported quality of life (QOL), functional outcomes, and decision satisfaction among mPC patients.After a clinic visit in which a treatment decision was made (baseline), mPC patients completed DLOC and QOL surveys. QOL was re-assessed at 2- and 4-months post-baseline. Mean scores for each QOL dimension (physical, emotional, cognitive, social, and role functioning) were compared by DLOC group using mixed effects models. Patient preferences for DLOC and provider communication techniques were similarly collected via survey.Median age of participants (N = 101) was 69 years (range: 49-92); most were White (80%) and married (82%). 62% reported using SDM. At baseline, there were no differences in QOL dimensions between DLOC groups. At 4 months, patient-directed (p = 0.01) and SDM (p = 0.03) were associated with better physical functioning than physician-directed decision-making, and there was an indication of potentially greater decision satisfaction among patients who reported patient-directed (p = 0.06) or SDM (p = 0.10). SDM was the most reported preferred DLOC.mPC patients reporting SDM had better physical functioning at 4 months than physician- or patient-directed decision-making, suggesting measurable benefit from patient involvement in decision-making. Future investigations of these associations in larger, more diverse populations can further clarify these previously unmeasured benefits of patient engagement in treatment decisions.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.