What do patients and health care professionals view as important attributes in radiotherapy decisions? Input for a breast cancer patient decision aid.

Autor: Raphael DB; Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Family Medicine, CAPHRI School for Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Radiotherapy, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands. Electronic address: d.raphael@nki.nl., Ter Stege JA; Department of Psychosocial Research and Epidemiology Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands. Electronic address: j.t.stege@nki.nl., Russell NS; Department of Radiotherapy, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands. Electronic address: n.russell@nki.nl., Boersma LJ; Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: liesbeth.boersma@maastro.nl., van der Weijden T; Department of Family Medicine, CAPHRI School for Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands. Electronic address: trudy.vanderweijden@maastrichtuniversity.nl.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2020 Feb; Vol. 49, pp. 149-156. Date of Electronic Publication: 2019 Nov 21.
DOI: 10.1016/j.breast.2019.11.005
Abstrakt: Background and Aim: There is increased attention for shared decision making (SDM) when deciding on radiotherapy for selected patients with Stage 0-2 breast cancer. This study aimed to explore patients' and health care professionals' experiences, decisional attributes and needs as input for the development of a patient decision aid to facilitate SDM.
Methods: Qualitative semi-structured interviews were held with fifteen breast cancer patients, being confronted with a radiotherapy decision one month to eight years earlier. Another fifteen interviews were held with professionals specialized in breast cancer care. Interviews were transcribed verbatim and independently coded by two researchers, who agreed upon relevant issues.
Results: Most patients made their decision by weighing the advantages of radiotherapy, i.e. comparing the decrease in recurrence risk with and without radiotherapy, and disadvantages, i.e. possible side effects. Patients and professionals agreed that recurrence risks should be communicated, but not on how to deal with uncertainty. There was wide variation in which, and how, side effects were explained by professionals. The most common side effects mentioned by both patients and professionals were skin toxicity, fatigue and breast deformity.
Conclusion: Patients and professionals appeared to agree on what type of attributes should be communicated during SDM on radiotherapy, but how this should be done is up for discussion. To ensure the patient's voice these attributes and needs need to be incorporated in the risk communication and value elicitation part of the patient decision aid. The format in which the attributes are communicated should be critically evaluated.
Competing Interests: Declaration of competing interest All authors declare to have no conflict of interest.
(Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: