Adapting the coping in deliberation (CODE) framework: a multi-method approach in the context of familial ovarian cancer risk management.

Autor: Witt J; Department of Palliative Care, Policy and Rehabilitation, King's College London, London, UK. Electronic address: jana.witt@kcl.ac.uk., Elwyn G; Dartmouth Center for Healthcare Delivery Science, Hanover, NH, USA; Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH, USA., Wood F; Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK., Rogers MT; All Wales Medical Genetics Service, Cardiff, UK., Menon U; Women's Cancer, Institute for Women's Health, University College London, London, UK., Brain K; Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2014 Nov; Vol. 97 (2), pp. 200-10. Date of Electronic Publication: 2014 Jul 14.
DOI: 10.1016/j.pec.2014.07.004
Abstrakt: Objective: To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer.
Methods: We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework.
Results: The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified.
Conclusions: The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO.
Practice Implications: Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care.
(Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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