Adaptation and qualitative evaluation of encounter decision aids in breast cancer care

Hahlweg, Pola; Witzel, Isabell; Müller, Volkmar; Elwyn, Glyn; Durand, Marie-Anne; Scholl, Isabelle

doi:10.1007/s00404-018-5035-7

Cited by 14 publications

(13 citation statements)

References 42 publications

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“…This is to our knowledge the first study to conduct cognitive interviews with men to adapt a prostate cancer screening decision aid after its translation. In terms of themes, our results are in line with similar studies conducted with cognitive interviews to evaluate decision aids for other preference-sensitive health decisions 36–38 43. Previous studies have shown that messages that do not clearly support cancer screening are seen as counterintuitive and that the benefits of screening are overestimated 44–46.…”

Section: Discussionsupporting

confidence: 88%

Translation and cultural adaptation of a prostate cancer screening decision aid: a qualitative study in Portugal

et al. 2020

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ObjectivesTo translate and culturally adapt an English language patient decision aid addressing prostate cancer screening, so it can be used by Portuguese men.DesignQualitative study. We followed the European Centre for Disease Prevention and Control’s (ECDC) five-step, stakeholder-based approach to adapting health communication materials: (1) selection of materials and process coordinators, (2) early review, (3) translation and back translation, (4) comprehension testing with cognitive semi-structured interviews and (5) proofreading. Content analysis was performed using Ligre software.Setting and participantsCognitive interviews with 15 men to refine a decision aid after its translation. Eligible participants were Portuguese native-speaking men aged 55–69 years old recruited from the local community (urban and suburban) of Oporto district through advertisements in social media and senior universities between January and March 2019. A previous diagnosis of prostate cancer was the single exclusion criterion.ResultsFive main themes are presented: informational content, information comprehension, sociocultural appropriateness, feelings and main message and personal perspective concerning prostate cancer screening. Most men found the translated version of the decision aid to be clear, comprehensive and appropriate for its target population, although some suggested that medical terms could be a barrier. The data collected from men’s interviews afforded the researchers the opportunity to clarify concepts and expand existing content.ConclusionsA decision aid was successfully translated and adapted to the Portuguese cultural setting. Our ECDC based approach can be replicated by other workgroups to translate and culturally adapt decision aids.

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Section: Discussionsupporting

confidence: 88%

Translation and cultural adaptation of a prostate cancer screening decision aid: a qualitative study in Portugal

et al. 2020

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“…35 Estudos internacionais apresentam resultados semelhantes a esse estudo no que se refere à vontade dos pacientes de serem incluídos na decisão, no entanto, apresentam barreiras individuais e estruturais do sistema de saúde. [36][37][38] Implicações para a prática profissional…”

Section: Valorização Da Autonomia Dos Homens Na Tomada De Decisão Clínicaunclassified

decisão clínica compartilhada diante dos riscos do rastreamento do câncer de próstata

Santos

Abreu

Engstrom

2021

Rev Bras Med Fam Comunidade

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Introdução: Evidências atuais apontam para desiquilíbrio entre os benefícios e danos com a prática do rastreamento do câncer de próstata, podendo provocar consideráveis riscos à saúde dos homens. Tal afirmativa fundamentou a recomendação do Ministério da Saúde sobre não estimular a realização dessa prática e a necessidade de discutir todas as implicações desses exames quando o homem solicitar sua realização. Objetivo: Analisar a percepção e experiências de homens e médicos/as sobre a tomada de decisão compartilhada para o rastreamento do câncer de próstata no Brasil. Método: Foi realizado um estudo qualitativo e exploratório, a partir de um grupo focal com homens na maturidade da idade (média: 51 anos) e entrevistas semiestruturadas com médicos/as de unidades básicas de saúde, de diferentes estados do Brasil. Abordagem analítica qualitativa, cujos dados foram categorizados pela análise de conteúdo. Resultados: Identificou-se desconhecimento dos homens sobre os possíveis danos relacionados ao rastreamento desse câncer, além de barreiras de cunho pessoal, cultural e na organização do processo de trabalho, que demonstraram dificultar à comunicação clínica durante a consulta na atenção primária à saúde (APS). De outra parte, os homens referem desejo de maior participação nas escolhas sobre sua saúde, mencionando a internet como uma ferramenta frequentemente utilizada para diminuir a disparidade de conhecimento na relação clínica. Os achados também apresentam estratégias utilizadas pelos médicos/as, como recursos gráficos e ferramentas de comunicação, que ajudam a incluir diferentes perfis de homens na tomada de decisão. Conclusão: A investigação demonstrou que, embora haja avanços em relação ao debate de possíveis implicações danosas do rastreamento do câncer de próstata e exemplos de abordagens inclusivas, essa prática ainda não está consolidada no Brasil, revelando a necessidade de incentivar a participação do homem nas decisões que influenciam diretamente sua qualidade de vida e bem-estar. Dessa forma, há a necessidade de investir em estratégias que facilitem a comunicação médico/paciente e ampliem o debate sobre as possíveis implicações do rastreamento entre os profissionais inseridos na APS e na população.

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“…To implement SDM and PDA effectively, HCP training is warranted. Studies have reported the lack of training to be contributing factors to lack of engagement of patients in SDM and proper use of PDAs [41,42]. The benefits of training are well evidenced [43,44] and it should be a pre-requisite for SDM and PDA implementation [45].…”

Section: Plos Onementioning

confidence: 99%

Factors influencing implementation of an insulin patient decision aid at public health clinics in Malaysia: A qualitative study

Tong

Lee

et al. 2020

PLoS ONE

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Background Many patient decision aids (PDAs) are developed in academic settings by academic researchers. Academic settings are different from public health clinics where the focus is on clinical work. Thus, research on implementation in public health settings will provide insights to effective implementation of PDA in real-world settings. This study explores perceived factors influencing implementation of an insulin PDA in five public health clinics. Methods This study adopted a comparative case study design with a qualitative focus to identify similarities and differences of the potential barriers and facilitators to implementing the insulin PDA across different sites. Focus groups and individual interviews were conducted with 28 healthcare providers and 15 patients from five public health clinics under the Ministry of Health in Malaysia. The interviews were transcribed verbatim and analysed using the thematic approach. Results Five themes emerged which were: 1) time constraint; 2) PDA costs; 3) tailoring PDA use to patient profile; 4) patient decisional role; and 5) leadership and staff motivation. Based on the interviews and drawing on observations and interview reflection notes, time constraint emerged as the common prominent factor that cut across all the clinics, however, tailoring PDA use to patient profile; patient decisional role; leadership and staff motivation varied due to the distinct challenges faced by specific clinics. Among clinics from semi-urban areas with more patients from limited education and lower socio-economic status, patients’ ability to comprehend the insulin PDA and their tendency to rely on their doctors and family to make health decisions were felt to be a prominent barrier to the insulin PDA implementation. Staff motivation appeared to be stronger in most of the clinics where specific time was allocated to diabetes team to attend to diabetes patients and this was felt could be a potential facilitator, however, a lack of leadership might affect the insulin PDA implementation even though a diabetes team is present. Conclusions This study found time constraint as a major potential barrier for PDA implementation and effective implementation of the insulin PDA across different public health clinics would depend on leadership and staff motivation and, the need to tailor PDA use to patient profile. To ensure successful implementation, implementers should avoid a ‘one size fits all’ approach when implementing health innovations.

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Adaptation and qualitative evaluation of encounter decision aids in breast cancer care

Cited by 14 publications

References 42 publications

Translation and cultural adaptation of a prostate cancer screening decision aid: a qualitative study in Portugal

Translation and cultural adaptation of a prostate cancer screening decision aid: a qualitative study in Portugal

decisão clínica compartilhada diante dos riscos do rastreamento do câncer de próstata

Factors influencing implementation of an insulin patient decision aid at public health clinics in Malaysia: A qualitative study

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