Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Health Expect. 2022 Feb;25(1):232-244. doi: 10.1111/hex.13368. Epub 2021 Oct 28.
The aim of this study was to develop a patient decision aid (pDA) that could support patients with breast cancer (BC) in making an informed decision about breast reconstruction (BR) after mastectomy.
The development included four stages: (i) Establishment of a multidisciplinary team; (ii) Needs assessment consisting of semi-structured interviews in patients and a survey among healthcare professionals (HCPs); (iii) Creation of content, design and technical system; and (iv) Acceptability and usability testing using a think-aloud approach in patients and interviews among HCPs and representatives of the Dutch Breast Cancer Patient Organization.
From the needs assessment, three themes were identified: Challenging period to make a decision, Diverse motivations for a personal decision and Information needed to make a decision about BR. HCPs valued the development of a pDA, especially to prepare patients for consultation. The pDA that was developed contained three parts: first, a consultation sheet for oncological breast surgeons to introduce the choice; second, an online tool including an overview of reconstructive options, the pros and cons of each option, information on the consequences of each option for daily life, exercises to clarify personal values and patient stories; and third, a summary sheet with patients' values, preferences and questions to help inform and guide the discussion between the patient and her plastic surgeon. The pDA was perceived to be informative, helpful and easy to use by patients and HCPs.
Consistent with information needs, a pDA was developed to support patients with BC who consider immediate BR in making an informed decision together with their plastic surgeon.
Patients participated in the needs assessment and in acceptability and usability testing.
本研究旨在开发一种患者决策辅助工具（pDA），以支持乳腺癌（BC）患者在接受乳房切除术（mastectomy）后就乳房重建（BR）做出知情决策。
该开发过程包括四个阶段：（i）建立多学科团队；（ii）需求评估，包括对患者进行半结构化访谈以及对医疗保健专业人员（HCPs）进行调查；（iii）创建内容、设计和技术系统；（iv）使用患者的出声思维方法以及对 HCPs 和荷兰乳腺癌患者组织代表进行访谈来进行可接受性和可用性测试。
从需求评估中确定了三个主题：做出决策的困难时期、个人决策的不同动机以及做出 BR 决策所需的信息。HCPs 重视 pDA 的开发，特别是为了让患者为咨询做好准备。开发的 pDA 包含三个部分：第一，为肿瘤乳房外科医生准备的咨询表，以介绍选择；第二，在线工具，包括重建选项概述、每种选项的优缺点、每种选项对日常生活影响的信息、用于澄清个人价值观的练习以及患者故事；第三，一张总结表，其中包含患者的价值观、偏好和问题，以帮助告知和指导患者与其整形外科医生之间的讨论。患者和 HCPs 都认为 pDA 内容丰富、有帮助且易于使用。
根据信息需求，开发了一种 pDA，以支持考虑立即进行 BR 的 BC 患者与她的整形外科医生一起做出知情决策。
患者参与了需求评估以及可接受性和可用性测试。
