Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
South West Sydney Clinical Campuses, UNSW Medicine and Health, University of New South Wales, Liverpool, NSW 2160, Australia.
Curr Oncol. 2024 Jun 28;31(7):3713-3737. doi: 10.3390/curroncol31070274.
Currently, there are no resources to support culturally and linguistically diverse (CALD) women with breast cancer to make decisions about undergoing breast reconstruction (BR). This study evaluated the usability and acceptability of decision aids (DAs) for Vietnamese- and Arabic-speaking women. This two-phase qualitative recruited Vietnamese- (Phase 1) and Arabic-speaking (Phase 2) adult (age ≥ 18 years) women who were diagnosed with breast cancer and could read Vietnamese/Arabic. Women participated in either think-aloud telephone interviews (Phase 1) or semi-structured telephone interviews (Phase 2) and provided feedback on the DA. Interviews were audio-recorded, translated, and transcribed from Vietnamese/Arabic to English, and inductive thematic analysis was undertaken. Additionally, Arabic-speaking women completed the Preparation for Decision Making (PrepDM) scale in Round 2. Twenty-five women were recruited in two phases (Phase 1: Vietnamese-speaking women, = 14; Phase 2: Arabic-speaking, = 11). Three themes were developed in Phase 1: (1) DA content and reception; (2) linguistic attributes and cultural appropriateness; and (3) factors that improve the DAs' impact. Three themes were developed in Phase 2: (1) varying perceptions of DA content; (2) linguistic and cultural suitability of information; and (3) impact of DA on decision making. Women from both phases identified areas for improvement: minimising the use of medical terminology, considering the cultural taboos associated with the word 'breast', and addressing remaining information gaps. Both language DAs were generally perceived as acceptable and useful in providing information about BR options and prompting women's reflections about the suitability of BR as part of their treatment. The mean PrepDM score for Arabic-speaking women in Round 2 was 4.8/5 (SD = 0.3). Further work is needed to ensure that culturally adapted DAs take into account the myriad of information needs and health literacy levels. The key role of healthcare professionals in shared decision making among CALD populations should also be considered.
目前，没有资源可以为患有乳腺癌的具有文化和语言多样性（CALD）的女性提供支持，以帮助她们做出是否进行乳房重建（BR）的决定。本研究评估了针对讲越南语和阿拉伯语的女性使用决策辅助工具（DA）的可用性和可接受性。这是一个两阶段的定性研究，招募了讲越南语（第 1 阶段）和阿拉伯语（第 2 阶段）的成年（年龄≥18 岁）、被诊断患有乳腺癌且能够阅读越南语/阿拉伯语的女性。女性通过电话进行了出声思考访谈（第 1 阶段）或半结构化电话访谈（第 2 阶段），并对 DA 提供了反馈。访谈内容以越南语/阿拉伯语录音、翻译和转录为英语，并进行了归纳主题分析。此外，阿拉伯语女性在第 2 轮中完成了决策准备度量表（PrepDM）。两阶段共招募了 25 名女性（第 1 阶段：讲越南语的女性， = 14；第 2 阶段：讲阿拉伯语的女性， = 11）。第 1 阶段产生了 3 个主题：（1）DA 内容和接收；（2）语言属性和文化适宜性；（3）提高 DAs 影响的因素。第 2 阶段产生了 3 个主题：（1）对 DA 内容的不同看法；（2）信息的语言和文化适宜性；（3）DA 对决策的影响。两个阶段的女性都确定了需要改进的领域：尽量减少使用医学术语，考虑与“乳房”一词相关的文化禁忌，并解决剩余的信息差距。两种语言的 DA 通常被认为是可以接受的，并且在提供关于 BR 选择的信息以及促使女性思考 BR 是否适合作为其治疗的一部分方面非常有用。第 2 轮中阿拉伯语女性的平均 PrepDM 得分为 4.8/5（SD=0.3）。需要进一步努力确保文化适应的 DA 考虑到众多的信息需求和健康素养水平。还应考虑医疗保健专业人员在具有文化和语言多样性的人群中共同决策中的关键作用。
