Considering Breast Reconstruction after Mastectomy: A Patient Decision Aid Video and Workbook

Hoffman, Aubri; Cantor, Scott B.; Fingeret, Michelle Cororve; Housten, Ashley J.; Hanson, Summer E.; McGee, Jennifer H.; Pietz, Jordan T.; Bennett, Alina; Volk, Robert J.; Reece, Gregory P.

doi:10.1097/gox.0000000000002500

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…It is worth noting that the effects of DAs on women facing BR were mixed and inconclusive. Some studies (Hoffman et al, 2019; Lin et al, 2021) had indicated that DAs played a positive effect on the BR decision‐making process, such as decreasing decision conflict, decision regret and improving BR knowledge, decision satisfaction. However, there was also research (Politi et al, 2020) showing that DAs have little impact on the BR decision‐making quality.…”

Section: Introductionmentioning

confidence: 99%

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Effects of decision aids on breast reconstruction: A systematic review and meta‐analysis of randomised controlled trials

Yang

Lin

Zhang

et al. 2022

Journal of Clinical Nursing

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Aims and Objectives:To systematically evaluate the effects of decision aids for women facing breast reconstruction decision on decision conflict, decision regret, knowledge, satisfaction, anxiety and depression.Background: Breast reconstruction decision is not good or bad and should be guided by clinical evidence and patient preferences. Decision aids can increase the patient's decision-making enthusiasm and ability, improve the quality of decision and promote shared decision-making between patients and medical staff.Design: Systematic review and meta-analysis.Methods: Eight databases were conducted from the establishment of the database until October 2021. The PRISMA checklist was selected for analysis in this paper. The meta-analysis was conducted in Review Manager 5.3. The quality of the studies was assessed using the Cochrane risk-of-bias tool. The result is decision conflict, decision regret, knowledge and other secondary outcomes. Sensitivity analysis and subgroup analysis were also conducted.Results: A total of twelve randomised controlled trials (RCTs) were included in the systematic review and meta-analysis. Meta-analysis revealed that decision aids could significantly reduce decision conflict and decision regret, improve knowledge, satisfaction and depression and had no influence on anxiety. Conclusions:The results of the systematic review and meta-analysis reviewed the positive effect of decision aids on the decision-making of women facing postmastectomy breast reconstruction. In the future, more well-designed RCTs are needed to confirm the effects of decision aids on the decision-making of breast reconstruction and nurses should be encouraged to take part in the development of decision aids in accordance with strict standards and apply them to breast cancer patients considering postmastectomy breast reconstruction. Relevance to clinical practice:Our study provides evidence for the effectiveness of decision aids on breast reconstruction and points to the important role of healthcare providers in the use of decision aids and in facilitating shared decision-making.

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Section: Introductionmentioning

confidence: 99%

“…It is worth noting that the effects of DAs on women facing BR were mixed and inconclusive. Some studies (Hoffman et al, 2019; Lin…”

Section: Introductionmentioning

confidence: 99%

Effects of decision aids on breast reconstruction: A systematic review and meta‐analysis of randomised controlled trials

Yang

Lin

Zhang

et al. 2022

Journal of Clinical Nursing

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“…This exploratory study was not designed to test a hypothesis or generate a theory. Sample sizes were based on the international guidelines and were consistent with previous studies [18,19,28,[36][37][38][39]. For the questionnaire, the research team used descriptive statistics to summarize quantitative responses and semantic, critical realist thematic analyses [40] to analyze qualitative responses.…”

Section: Discussionmentioning

confidence: 99%

Decision Making When Cancer Becomes Chronic: Needs Assessment for a Web-Based Medullary Thyroid Carcinoma Patient Decision Aid

Shojaie¹,

Hoffman²,

Amaku³

et al. 2021

JMIR Form Res

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Background In cancers with a chronic phase, patients and family caregivers face difficult decisions such as whether to start a novel therapy, whether to enroll in a clinical trial, and when to stop treatment. These decisions are complex, require an understanding of uncertainty, and necessitate the consideration of patients’ informed preferences. For some cancers, such as medullary thyroid carcinoma, these decisions may also involve significant out-of-pocket costs and effects on family members. Providers have expressed a need for web-based interventions that can be delivered between consultations to provide education and prepare patients and families to discuss these decisions. To ensure that these tools are effective, usable, and understandable, studies are needed to identify patients’, families’, and providers’ decision-making needs and optimal design strategies for a web-based patient decision aid. Objective Following the international guidelines for the development of a web-based patient decision aid, the objectives of this study are to engage potential users to guide development; review the existing literature and available tools; assess users’ decision-making experiences, needs, and design recommendations; and identify shared decision-making approaches to address each need. Methods This study used the decisional needs assessment approach, which included creating a stakeholder advisory panel, mapping decision pathways, conducting an environmental scan of existing materials, and administering a decisional needs assessment questionnaire. Thematic analyses identified current decision-making pathways, unmet decision-making needs, and decision support strategies for meeting each need. Results The stakeholders reported wide heterogeneity in decision timing and pathways. Relevant existing materials included 2 systematic reviews, 9 additional papers, and multiple educational websites, but none of these met the criteria for a patient decision aid. Patients and family members (n=54) emphasized the need for plain language (46/54, 85%), shared decision making (45/54, 83%), and help with family discussions (39/54, 72%). Additional needs included information about uncertainty, lived experience, and costs. Providers (n=10) reported needing interventions that address misinformation (9/10, 90%), foster realistic expectations (9/10, 90%), and address mistrust in clinical trials (5/10, 50%). Additional needs included provider tools that support shared decision making. Both groups recommended designing a web-based patient decision aid that can be tailored to (64/64, 100%) and delivered on a hospital website (53/64, 83%), focuses on quality of life (45/64, 70%), and provides step-by-step guidance (43/64, 67%). The study team identified best practices to meet each need, which are presented in the proposed decision support design guide. Conclusions Patients, families, and providers report multifaceted decision support needs during the chronic phase of cancer. Web-based patient decision aids that provide tailored support over time and explicitly address uncertainty, quality of life, realistic expectations, and effects on families are needed.

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“…[16][17][18] Evidence-based information about the available reconstruction options is needed, including the possible complications, HRQOL prognosis and patients' perception of cosmetic results to help patients know what to expect after BR. [19][20][21] In the past decade, patient-reported outcomes (PROs) have been used to understand how BR impacts a patient's life and to measure the value of BR. 7 22-26 Among these PROs, the BREAST-Q, 24 the first BR-specific instrument, has been most commonly used worldwide because of its high validity.…”

Section: Introduction Background and Rationalementioning

confidence: 99%

“… 16–18 Evidence-based information about the available reconstruction options is needed, including the possible complications, HRQOL prognosis and patients’ perception of cosmetic results to help patients know what to expect after BR. 19–21 …”

Section: Introductionmentioning

confidence: 99%

Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study

et al. 2021

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IntroductionThe aim of breast reconstruction (BR) is to improve patients’ health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient’s life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR).Methods and analysisThis ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system.Ethics and disseminationThis study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan’s Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal.Trial registration numberUMIN000032177.

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Considering Breast Reconstruction after Mastectomy: A Patient Decision Aid Video and Workbook

Cited by 13 publications

References 21 publications

Effects of decision aids on breast reconstruction: A systematic review and meta‐analysis of randomised controlled trials

Effects of decision aids on breast reconstruction: A systematic review and meta‐analysis of randomised controlled trials

Decision Making When Cancer Becomes Chronic: Needs Assessment for a Web-Based Medullary Thyroid Carcinoma Patient Decision Aid

Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study

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