Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Sydney, Australia.
Psychooncology. 2017 Oct;26(10):1618-1624. doi: 10.1002/pon.4346. Epub 2017 Jan 30.
Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction.
Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N = 36) and with their healthcare providers (N = 6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders.
Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey.
These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources.
被诊断患有乳腺癌或导管原位癌的女性，以及那些有遗传易感性患上这种疾病的女性，都面临着一个艰难的决定，即是否在乳房切除术后进行乳房重建。作为一项大型随机对照试验的一部分，这项定性研究调查了女性使用乳房重建决策辅助工具（BRECONDA）的体验，以及卫生专业人员对该资源对患者关于乳房重建的知识和决策的影响的反馈。
对使用 BRECONDA 干预措施的女性（N=36）和她们的医疗保健提供者（N=6）进行了半结构化访谈。所有访谈都逐字转录，并由 3 位独立的编码员进行主题分析。
参与者报告了总体上的积极印象，所有受访者都认为该决策辅助工具是考虑重建手术的女性的有用资源。对患者访谈的主题分析揭示了 4 个主题：总体印象和美学；个人相关性和实用性；引入 BRECONDA；以及优势和建议的改进。对卫生专业人员访谈的分析也揭示了 4 个主题：对 BRECONDA 的需求、BRECONDA 的影响、在使用决策辅助工具时可能出现的潜在困难，以及向患者推荐 BRECONDA。患者表示，他们在决策过程的所有阶段都从该资源中受益，最大的受益是那些在乳房重建早期的患者。
这些发现支持将 BRECONDA 用作临床咨询和其他信息来源的辅助工具。
