Decisional Aid Intervention for Women Considering Breast Reconstruction

针对考虑乳房重建的女性的决策性援助干预

• 批准号: 8332282
• 负责人: Sharon L Manne
• 金额: $ 8.92万
• 依托单位: UNIV OF MED/DENT NJ-R W JOHNSON MED SCH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-13 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8332282
• 关键词: Address; Age-Years; Anxiety; Area; Attitude; Benefits and Risks; Breast; Cancer Survivor; Caring; Complication; Conflict (Psychology); Consultations; Contracture; Cosmetics; Counseling; Data; Decision Aid; Decision Making; Development; Diagnosis; Disadvantaged; Distress; Emotional; Feedback; Implant; Infection; Intention; Intervention; Interview; Knowledge; Long-Term Effects; Mammaplasty; Mastectomy; Methods; Minority; Newly Diagnosed; Online Systems; Operative Surgical Procedures; Outcome; Patients; Phase; Plastic Surgeon; Play; Preparation; Procedures; Process; Provider; Quality of life; Radiation; Randomized Clinical Trials; Reaction; Readiness; Risk; Role; Sampling; Shapes; Staging; Structure; Sum; Surgeon; Testing; Time; Tissue Expanders; Tissues; Woman; alternative treatment; base; breast cancer diagnosis; cost; experience; improved; interest; malignant breast neoplasm; preference; prototype; psychologic; psychosocial; radiation effect; reconstruction; satisfaction; treatment as usual; usability

DESCRIPTION (provided by applicant): The decision whether to pursue breast reconstruction (BR) can be challenging. Women must weigh the importance of potential benefits of the procedure and their personal values and preferences against the risks associated with the procedure and decide what type of reconstruction to have should they pursue it. The decision is typically made in a stressful circumstance, which is immediately after the initial diagnosis of breast cancer. Complicating matters is the fact that there is evidence to suggest that there are variable rates of satisfaction with the cosmetic outcomes of BR. Outcomes may not be in line with what the patient initially expected. BR can be a difficult decision made under stressful circumstances and women may not be as well- informed about the long-term effects as they could be. When patients are faced with treatment decisions for which personal values and quality of life issue play a role and there are multiple treatment choices, decision support in the form of decision aids can be helpful to the process of making a well-informed choice. Decision support aids are a strategy used as an adjunct to practitioners' counseling to facilitate their understanding of the treatment options, the advantages and disadvantages of each option, consideration of the personal importance they attach to the benefits and risks of each alternative, and to encourage active participation with the care provider in deciding which option to pursue. We propose to develop a web-based DA for women being offered BR. We will accomplish this in three phases. Phase 1 is a developmental phase where the basic DA content is developed by the study team with input from patients who have undergone BR, were offered BR and decided against it, or are considering BR. We will include input from minority women, women over 65 years of age, and less educated women, who have less access to BR. Phase 2 consists of gathering feedback terms on the DA prototype from women who have undergone BR, women who were offered BR and chose not to have it, and women who are considering BR. Again, feedback from minority women, women over 65 years of age, and less educated women will be included. The BR Decision Aid (BRDA) will then be finalized. Phase 3 will be a usability and feasibility pilot test of the DA with a sample of women considering BR. The study has one primary aim and two secondary aims. The primary aim is to evaluate the usability and feasibility of a decisional aid to assist women with making the decision to undergo BR. The secondary aims are to examine the acceptability of the BRDA and to provide preliminary data on the impact of BRDA on BR knowledge, values, decisional conflict, preparedness, BR interest, and anxiety.

描述（由申请人提供）：是否进行乳房再造（BR）的决定可能具有挑战性。女性必须权衡手术的潜在好处的重要性和他们的个人价值观和偏好与手术相关的风险，并决定他们应该追求什么类型的重建。这个决定通常是在压力的情况下做出的，这是在最初诊断乳腺癌后立即做出的。使问题复杂化的是，有证据表明，对BR美容效果的满意度存在差异。结果可能与患者最初的预期不一致。BR可能是一个困难的决定，在压力的情况下，妇女可能不知道的长期影响，因为他们可以。当患者面临个人价值观和生活质量问题发挥作用的治疗决策时，有多种治疗选择，决策辅助工具形式的决策支持有助于做出明智选择的过程。决策支持辅助工具是一种策略，用作从业者咨询的辅助手段，以促进他们对治疗方案的理解，每种方案的优点和缺点，考虑他们对每种方案的利益和风险的个人重要性，并鼓励护理提供者积极参与决定采取哪种方案。我们建议开发一个基于网络的DA为妇女提供BR。我们将分三个阶段完成这项工作。第1阶段是一个发展阶段，其中基本DA内容由研究团队根据接受过BR、接受BR但决定不接受或正在考虑BR的患者的意见制定。我们将包括少数民族妇女、65岁以上妇女和受教育程度较低的妇女的投入，她们较少获得BR。第2阶段包括从接受BR的女性、接受BR但选择不接受BR的女性以及正在考虑BR的女性中收集关于DA原型的反馈条款。少数民族妇女、65岁以上妇女和教育程度较低的妇女的反馈也将包括在内。然后将最后确定BR决策辅助工具（布尔达）。第三阶段将是DA的可用性和可行性试点测试，样本是考虑BR的女性。这项研究有一个主要目标和两个次要目标。其主要目的是评估决策援助的可用性和可行性，以帮助妇女作出接受BR的决定。次要目的是检查布尔达的可接受性，并提供关于布尔达对BR知识、价值观、决策冲突、准备、BR兴趣和焦虑的影响的初步数据。