TY - JOUR
T1 - Considering Breast Reconstruction after Mastectomy
T2 - A Patient Decision Aid Video and Workbook
AU - Hoffman, Aubri S.
AU - Cantor, Scott B.
AU - Fingeret, Michelle C.
AU - Housten, Ashley J.
AU - Hanson, Summer E.
AU - McGee, Jennifer H.
AU - Pietz, Jordan T.
AU - Bennett, Alina
AU - Volk, Robert J.
AU - Reece, Gregory P.
N1 - Funding Information:
From the *Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Tex.; †Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Tex.; ‡Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.; and §Department of Creative Services, The University of Texas MD Anderson Cancer Center, Houston, Tex.This work was supported by a grant from The University of Texas MD Anderson Cancer Center Duncan Family Institute for Cancer Prevention and Risk Assessment. The statements presented in this work are solely the responsibility of the authors and do not necessarily represent the views of The University of Texas MD Anderson Cancer Center or the Duncan Family Institute for Cancer Prevention and Risk Assessment. Received for publication June 18, 2019; accepted August 21, 2019. Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Publisher Copyright:
© 2019 Lippincott Williams and Wilkins. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background: Women report difficulty understanding and personalizing breast reconstruction information during the complex and time-limited period of cancer treatment planning. Patient decision AIDS can help patients become well informed, form realistic expectations, prepare to communicate with the surgical team, and be more satisfied with their decision-making process. Methods: We engaged patients, providers, and stakeholders in a user-centered design process to develop an online patient decision aid video and interactive workbook for breast reconstruction after mastectomy. The video and workbook introduce breast reconstruction and compare the risks and benefits of 3 key decisions: Reconstruction versus no reconstruction, immediate versus delayed, and tissue-versus implant based. Pilot testing using cognitive interviews and pre-/postdecision aid questionnaires assessed acceptability, knowledge, and decision-making values. Results: After viewing the decision aid, patients (n = 20) scored 97.5% correct on a knowledge test; however, the factors driving their decisions were varied. All (n = 40) patients and providers/stakeholders provided over 80% positive acceptability ratings. 97.5% said they would recommend the video and workbook to other women with breast cancer. Conclusions: The Considering Breast Reconstruction after Mastectomy patient decision aid video and workbook show potential for improving informed decision-making. Delivery before the initial plastic surgery consultation was well supported as a way to give women time to process the information and prepare to talk with the surgical team about their options. The Personal Decision Worksheet shows potential for assessing patients' knowledge and the factors driving their personal decision-making process.
AB - Background: Women report difficulty understanding and personalizing breast reconstruction information during the complex and time-limited period of cancer treatment planning. Patient decision AIDS can help patients become well informed, form realistic expectations, prepare to communicate with the surgical team, and be more satisfied with their decision-making process. Methods: We engaged patients, providers, and stakeholders in a user-centered design process to develop an online patient decision aid video and interactive workbook for breast reconstruction after mastectomy. The video and workbook introduce breast reconstruction and compare the risks and benefits of 3 key decisions: Reconstruction versus no reconstruction, immediate versus delayed, and tissue-versus implant based. Pilot testing using cognitive interviews and pre-/postdecision aid questionnaires assessed acceptability, knowledge, and decision-making values. Results: After viewing the decision aid, patients (n = 20) scored 97.5% correct on a knowledge test; however, the factors driving their decisions were varied. All (n = 40) patients and providers/stakeholders provided over 80% positive acceptability ratings. 97.5% said they would recommend the video and workbook to other women with breast cancer. Conclusions: The Considering Breast Reconstruction after Mastectomy patient decision aid video and workbook show potential for improving informed decision-making. Delivery before the initial plastic surgery consultation was well supported as a way to give women time to process the information and prepare to talk with the surgical team about their options. The Personal Decision Worksheet shows potential for assessing patients' knowledge and the factors driving their personal decision-making process.
UR - http://www.scopus.com/inward/record.url?scp=85080151701&partnerID=8YFLogxK
U2 - 10.1097/GOX.0000000000002500
DO - 10.1097/GOX.0000000000002500
M3 - Article
C2 - 31942296
AN - SCOPUS:85080151701
VL - 7
JO - Plastic and Reconstructive Surgery - Global Open
JF - Plastic and Reconstructive Surgery - Global Open
SN - 2169-7574
IS - 11
M1 - e2500
ER -