Abstract
BackgroundIt is known that the use of a Patient Decision Aid (PtDA), combined with advice for professionals on how and when to use it, can enhance the involvement of patients in the treatment decision. However, we need more knowledge with respect to the intention-behaviour gap. This study aims to analyse patients’ experiences with the Shared Decision Making (SDM) process to find clues to close this gap.MethodsThis qualitative study was part of a pilot study aiming to implement SDM in early adopter breast cancer teams. Patients were given access to a personalised PtDA. Breast cancer teams were instructed on how and when to deliver the PtDA. We interviewed 20 patients about their experience with the PtDA and SDM in general.ResultsMost patients experienced SDM, though to a certain extent. Choice talk and option talk were commonly experienced, however the elicitation of preferences and decision talk was rare. The PtDA was used by the majority of patients (N = 13), all indicating that it was useful, especially to recall all the information given. Patients appreciated the contribution of breast cancer nurses in the SDM process. They considered them as true case managers, easy to approach and supportive.ConclusionAlthough patients felt well-informed and satisfied about risk-communication, the elicitation of preferences appeared very limited to non-existent. We recommend that breast cancer teams divide tasks in the SDM process and reallocate the elicitation of preferences to the nurses in a well-defined clinical pathway.
Highlights
It is known that the use of a Patient Decision Aid (PtDA), combined with advice for professionals on how and when to use it, can enhance the involvement of patients in the treatment decision
This study aimed to find clarification on the intention-behaviour gap from patient points of view by analysing: 1) the experiences of patients who were exposed to implementation strategies with regard to the Shared Decision Making (SDM) process; 2) the support patients experienced with regard to the PtDA
We identified key themes that appeared throughout all interviews by grouping the codes into larger themes: 1) perceived SDM and SDM steps during the clinical encounters; 2) delivery of the PtDA; 3) perceived usefulness of the PtDA
Summary
It is known that the use of a Patient Decision Aid (PtDA), combined with advice for professionals on how and when to use it, can enhance the involvement of patients in the treatment decision. This study aims to analyse patients’ experiences with the Shared Decision Making (SDM) process to find clues to close this gap. A large number of women with early stage breast cancer are faced with the choice between breast conserving or breast removing treatment. This is a preference sensitive decision, as both options have similar survival rates [1], while each patient may value the advantages and disadvantages of both therapies differently. Patients’ decisions are affected by the treatment options they were offered, the content and style of the information provided by their clinicians, the level of patient autonomy, and the time provided for decision making [4].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
