Implementing a breast cancer patient decision aid: Process evaluation using medical files and the patients' perspective.

Autor:	Savelberg, Wilma, Boersma, Liesbeth J., Smidt, Marjolein, Weijden, Trudy
Předmět:	BREAST tumor treatment EVALUATION of medical care CANCER patient psychology SCIENTIFIC observation ACQUISITION of data methodology CONFIDENCE intervals PATIENT decision making ATTITUDE (Psychology) RESEARCH methodology PHYSICIAN-patient relations MEDICAL personnel INTERVIEWING QUANTITATIVE research PATIENTS' attitudes HUMAN services programs DECISION making QUALITY assurance RESEARCH funding MEDICAL records SCALE analysis (Psychology) DESCRIPTIVE statistics ODDS ratio DATA analysis software LOGISTIC regression analysis
Zdroj:	European Journal of Cancer Care; Jul2021, Vol. 30 Issue 4, p1-11, 11p
Abstrakt:	Objective: Although patient decision aids (PtDAs) have been shown to improve shared decision‐making, integration into clinical care pathways remains limited. This study investigated, among other outcomes, the uptake of the PtDA by professionals and the uptake as perceived by patients. Methods: We performed a process evaluation among four breast cancer care teams that had been exposed to a multifaceted implementation strategy. Data were gathered by auditing patient files using a standardised data extraction sheet and conducting telephone interviews with patients using a structured interview guide. We analysed the data by using descriptive statistics. Results: We found that the implementation strategies, including advice on how and when to present the PtDA to the patient, were followed for 14% of the included patients (N = 84); 92% of the patients reported to have received a login code for the web‐based PtDA, while 67% logged in and used the PtDA at home. An important factor influencing the use was the clinician promoting it when delivering the PtDA (OR 9.95 95% CI 3.03–37.72). Discussion: The implementation strategies were followed in 14% of the patients, and a high delivery of the PtDA was achieved. Redesigning the care pathway and providing personal instruction on using PtDAs seem crucial. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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