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: 8047439
• 负责人: Sharon L Manne
• 金额: $ 28.03万
• 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 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8047439
• 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. PUBLIC HEALTH RELEVANCE: 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. We propose to develop a web-based decision aid for women being offered BR, evaluate its usability, feasibility, and acceptability, and gather preliminary data on its impact of BR knowledge, values, decisional conflict, preparedness, BR interest, and anxiety.

描述(由申请人提供)：是否进行乳房重建(BR)的决定可能是具有挑战性的。妇女必须权衡手术潜在益处的重要性及其个人价值观和偏好与手术相关的风险，并决定她们应该进行哪种类型的重建。这个决定通常是在压力很大的情况下做出的，紧随其后的是乳腺癌的初步诊断。更复杂的是，有证据表明，BR的美容效果有不同的满意率。结果可能与患者最初的预期不符。BR可能是在有压力的情况下做出的一个困难的决定，而女性可能并不像她们应该知道的那样充分了解它的长期影响。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定，并且有多种治疗选择时，决策辅助形式的决策支持可以帮助做出明智的选择。决策支持辅助是一种辅助从业者咨询的策略，以促进他们对治疗方案的了解，每个方案的优缺点，考虑他们个人对每个方案的好处和风险的重视，并鼓励他们积极参与护理提供者决定采取哪种方案。我们建议为正在提供BR的女性开发一个基于网络的DA。我们将分三个阶段实现这一目标。第一阶段是一个发展阶段，研究团队根据接受过BR、接受BR并决定不接受BR或正在考虑BR的患者的意见来开发基本的DA含量。我们将包括少数族裔妇女、65岁以上的妇女和受教育程度较低的妇女，她们获得BR的机会较少。第二阶段包括从经历过BR的女性、被提供BR但选择不接受BR的女性以及正在考虑BR的女性那里收集关于DA原型的反馈术语。同样，来自少数族裔女性、65岁以上女性和受教育程度较低的女性的反馈也将包括在内。然后将最终确定BR决策辅助工具(BRDA)。第三阶段将是发展议程的可用性和可行性试点测试，样本为考虑BR的妇女。这项研究有一个主要目标和两个次要目标。主要目的是评估辅助决策的可用性和可行性，以帮助妇女做出接受BR的决定。第二个目标是检查BRDA的可接受性，并提供关于BRDA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。 公共卫生相关性：决定是否进行乳房重建术(BR)可能是具有挑战性的。妇女必须权衡手术潜在益处的重要性及其个人价值观和偏好与手术相关的风险，并决定她们应该进行哪种类型的重建。我们建议为被提供BR的女性开发一个基于网络的决策辅助工具，评估其可用性、可行性和可接受性，并收集其对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。