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Efficacy of a Decision Aid in Breast Cancer Patients Considering Immediate Reconstruction: Results of a Randomized Controlled Trial.

التفاصيل البيبلوغرافية
العنوان: Efficacy of a Decision Aid in Breast Cancer Patients Considering Immediate Reconstruction: Results of a Randomized Controlled Trial.
المؤلفون: Ter Stege JA; From the Division of Psychosocial Research and Epidemiology., Woerdeman LAE; Department of Plastic and Reconstructive Surgery., Kieffer JM; From the Division of Psychosocial Research and Epidemiology., Sherman KA; Centre for Emotional Health, School of Psychological Sciences, Macquarie University Sydney., Agelink van Rentergem JA; From the Division of Psychosocial Research and Epidemiology., van Duijnhoven FH; Department of Surgical Oncology., van Huizum MA; Department of Plastic and Reconstructive Surgery., Gerritsma MA; From the Division of Psychosocial Research and Epidemiology., Kuenen M; From the Division of Psychosocial Research and Epidemiology., Corten EML; Plastic and Reconstructive Surgery, Erasmus Medical Center.; Plastic and Reconstructive Surgery, Franciscus Gasthuis & Vlietland., Kimmings NAN; Surgery, Slotervaart Medical Center., Ruhé QPQ; Plastic and Reconstructive Surgery, Meander Medical Center., Krabbe-Timmerman IS; Plastic and Reconstructive Surgery, Medical Center Leeuwarden., Van't Riet M; Department of Surgery, Reinier de Graaf Gasthuis., Hahn DEE; Department of Psychosocial Counseling., Witkamp AJ; Department of Surgery, University Medical Center Utrecht., Oldenburg HSA; Department of Surgical Oncology., Bleiker EMA; From the Division of Psychosocial Research and Epidemiology.; Family Cancer Clinic, Netherlands Cancer Institute, Antoni van Leeuwenhoek.; Department of Clinical Genetics, Leiden University Medical Center.
المصدر: Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Oct 01; Vol. 154 (4), pp. 706-722. Date of Electronic Publication: 2023 Oct 09.
نوع المنشور: Journal Article; Randomized Controlled Trial; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1306050 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1529-4242 (Electronic) Linking ISSN: 00321052 NLM ISO Abbreviation: Plast Reconstr Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore : Williams & Wilkins,
مواضيع طبية MeSH: Breast Neoplasms*/surgery , Breast Neoplasms*/psychology , Mammaplasty*/methods , Mammaplasty*/psychology , Mastectomy* , Decision Support Techniques* , Patient Satisfaction*, Humans ; Female ; Middle Aged ; Adult ; Decision Making ; Aged
مستخلص: Background: Breast cancer patients face complex decisions about immediate breast reconstruction (BR) after mastectomy. The authors evaluated the efficacy of an online decision aid in improving the decision-making process, decision quality, and health outcomes in breast cancer patients considering immediate BR.
Methods: In a multicenter, randomized, controlled trial, patients were allocated to either the intervention group, receiving care as usual with access to an online decision aid, or the control group, receiving care as usual with an information leaflet. The primary outcome was decisional conflict. Secondary outcomes assessed the process of decision-making (eg, preparation for decision-making, satisfaction with information), decision quality (decision regret, knowledge), and health outcomes (eg, satisfaction with BR outcomes, body image). Patients completed questionnaires at time (T) 0 (baseline); T1 (1 week after consultation with a plastic surgeon); and T2 (3 months) and T3 (12 months) after surgery.
Results: The authors included 250 patients. Decisional conflict decreased over time in both groups, with no between-group differences. Intervention participants felt better prepared for decision-making than controls ( P = 0.002). At T2, 87% of intervention participants were very satisfied with the information about BR, compared with 73% of control participants ( P = 0.011). No significant between-group differences were observed in any other outcome.
Conclusions: The authors' online decision aid was as effective in reducing decisional conflict as an information leaflet about immediate BR after mastectomy. However, the decision aid substantially improved the decision-making process by better preparing breast cancer patients for decisions about immediate BR.
Clinical Question/level of Evidence: Therapeutic, II.
(Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons.)
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تواريخ الأحداث: Date Created: 20231010 Date Completed: 20240924 Latest Revision: 20240924
رمز التحديث: 20240925
مُعرف محوري في PubMed: PMC11412569
DOI: 10.1097/PRS.0000000000011100
PMID: 37815283
قاعدة البيانات: MEDLINE
الوصف
تدمد:1529-4242
DOI:10.1097/PRS.0000000000011100