How and for whom are decision aids effective? Long-term psychological outcome of a randomized controlled trial in women with newly diagnosed breast cancer
| Autor: | Nina Ditsch, C. Caspari, Lisa Wang, Andrea Vodermaier, Michael Untch, Janna Koehm |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Coping (psychology) Decision Making Psychological intervention Breast Neoplasms Decisional conflict law.invention Conflict Psychological Breast cancer Randomized controlled trial Patient Education as Topic law Surveys and Questionnaires Adaptation Psychological Decision aids Medicine Humans Applied Psychology Internal-External Control Aged business.industry Retention rate Middle Aged medicine.disease Psychiatry and Mental health Physical therapy Linear Models Anxiety Female medicine.symptom business Clinical psychology |
| Zdroj: | Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 30(1) |
| ISSN: | 1930-7810 |
| Popis: | OBJECTIVE The current study evaluates the long-term psychological impact of a decision aid intervention for surgical and systemic treatment in women with newly diagnosed breast cancer from a previous reported randomized, controlled trial (Vodermaier et al., 2009). METHODS Patients (n = 111) were randomized into usual care, or a 20-min decision aid intervention plus an information brochure prior to consultation planning with the senior physician. The retention rate at 1 year was 88%. RESULTS Linear mixed model analyses demonstrated that the intervention group experienced less decisional conflict (p = .047; d = .19), which was driven by perceptions of a more effective choice (p = .029; d = .20) over time. Subgroup analyses revealed that patients in the intervention group who participated in chemotherapy decision making showed better long-term body image outcomes (p = .009; d = .44), which were mediated by reduced depressive coping (p = .049). No effects emerged for anxiety and depressive symptoms, or for quality of life. Internal health locus of control moderated group effects on 'uncertainty with the decision' (p = .003). CONCLUSIONS The study results provide novel evidence on the role of individual differences and the mechanisms behind decision aid effectiveness, and demonstrate the long-term impact of decision aid interventions on some indices of well-being. |
| Databáze: | OpenAIRE |
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