The implementation of a decision aid for women with early-stage breast cancer considering contralateral prophylactic mastectomy: A pilot study
| Autor: | Christobel Saunders, P. N. Butow, David Porter, Anastasia Serafimovska, Nicholas Zdenkowski, J. Jansen, Rachael Glassey |
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| Přispěvatelé: | RS: CAPHRI - R6 - Promoting Health & Personalised Care, Family Medicine |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Informed choice IMPACT Decision Making Breast Neoplasms Pilot Projects Target population PHYSICIANS RECOMMENDATIONS PREFERENCES Decision Support Techniques Contralateral breast cancer 03 medical and health sciences Medical benefit 0302 clinical medicine Breast cancer Contralateral Prophylactic Mastectomy parasitic diseases medicine Humans 030212 general & internal medicine ATTITUDES Stage (cooking) Mastectomy OUTCOMES COMPLICATIONS Pilot implementation business.industry CONSENSUS-STATEMENT 030503 health policy & services General Medicine medicine.disease CHOICE Prophylactic Mastectomy Decision aid CPM Implementation embryonic structures CONSULTATION Physical therapy Female 0305 other medical science business human activities Contralateral prophylactic mastectomy |
| Zdroj: | Patient Education and Counseling, 105(1), 74-80. Elsevier Ireland Ltd |
| ISSN: | 1873-5134 0738-3991 |
| Popis: | Objective: Despite little survival benefit and potential for harm, contralateral prophylactic mastectomy (CPM) rates are increasing amongst early-stage breast cancer patients at low contralateral breast cancer risk. We developed a CPM decision aid (DA) and conducted a pilot implementation. Methods: Surgeons and oncologists recruited eligible patients considering CPM. Consenting patients re-ceived the DA, completed a questionnaire and participated in a semi-structured interview. Clinicians were interviewed at study close. Results: Eleven clinicians and 31 patients participated. Three themes emerged: perceived utility and impact of the DA, disagreement regarding timing of delivery and target population, and implementation strategies. Both women and clinicians found the DA valuable, indicating it confirmed rather than changed preferences. Women (all of whom raised CPM themselves), preferred offering the DA early in treatment discussions whilst clinicians favoured targeting women who enquired about CPM. Conclusion: A DA about CPM is feasible and acceptable, but questions remain about the role of DAs in these types of decisions where one option has limited medical benefit. Practice implications: Some women have a high need to make an informed choice about CPM. Tools to support this could include a DA with a clear recommendation against CPM and an explanation why. (c) 2021 Published by Elsevier B.V. |
| Databáze: | OpenAIRE |
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