Would patients benefit from a decision aid for surgical decision making for rectal cancer? A qualitative analysis.

Abstract

e19139 Background: Rectal cancer surgery drastically changes the lives of patients. Decision aids available to guide patients on this decision are limited and of poor quality. We aimed to identify the content and delivery preferences of rectal cancer survivors who have faced this surgical decision and colorectal surgeons to guide future decision aid creation. Methods: We performed semi-structured interviews of survivors and their caregivers, as well as colorectal surgeons from April through August 2019. We purposively sampled patients treated surgically for rectal cancer and colorectal surgeons to include different demographics, surgical experiences, and practice types. We achieved thematic saturation in both groups. We performed dual coding and inductive thematic analysis. Results: A total of 30 participants were interviewed, 15 patients with 5 caregivers, and 10 colorectal surgeons. Patient demographics demonstrated an equal distribution of sex, age categories, and operative type. Physician demographics demonstrated a mean of 10±7 years in practice with 70% academic and 30% private practice. Main themes for both groups stated that a massive patient educational need exists throughout the continuum of disease into survivorship. Participants emphasized the need for a comprehensive educational tool to address these needs rather than a decision aid. Both wanted a tool that was personalized, simple, understandable, visually appealing, interactive, and delivered in a combination of modalities to capture the broadest audience. Patients also desired specific features like care timelines and resources. Surgeons felt than an educational tool would enhance patient/provider interaction by reinforcing material covered in clinic. Conclusions: A surgical decision aid for rectal cancer is not enough. Patients and surgeons acknowledged the need for a comprehensive tool to address the educational gap that exists through the continuum of rectal cancer care.