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: 8332282
• 负责人: Sharon L Manne
• 金额: $ 8.92万
• 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 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8332282
• 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.

描述（由申请人提供）：是否进行乳房重建（BR）的决定可能具有挑战性。妇女必须权衡该程序的潜在利益的重要性及其个人价值和偏好与程序相关的风险，并决定在追求哪种类型的重建。该决定通常是在压力大的情况下做出的，该情况是在最初诊断乳腺癌后立即做出的。使事情复杂化的事实是，有证据表明，对BR的美容结果的满意度有可变的速度。结果可能与患者最初的预期不符。在压力很大的情况下，BR可能是一个艰难的决定，妇女可能对长期效果的了解可能并不那么了解。当患者面临治疗决策时，个人价值观和生活质量发挥作用并且有多种治疗选择时，决策辅助工具形式的决策支持可能有助于做出明智的选择。决策支持AIDS是一种策略，用作从业人员咨询的辅助手段，以促进他们对治疗方案的理解，每种选择的优势和缺点，考虑到他们对每种替代方案的利益和风险所具有的个人重要性，并鼓励积极参与护理提供者在决定哪种选择方面进行选择。我们建议开发一个基于网络的DA，以供提供BR的女性。我们将在三个阶段完成此操作。第1阶段是一个发展阶段，研究团队开发了基本的DA含量，并提供了接受BR的患者的意见，并确定了BR，并考虑了BR。我们将包括来自少数族裔妇女，65岁以上的妇女以及受过教育较低的妇女的意见，而受教育程度较低的妇女获得了BR的机会。第2阶段包括收集有关BR的女性的DA原型的反馈条款，被提供BR并选择不提供BR的妇女以及正在考虑BR的妇女。同样，将包括来自少数民族妇女，65岁以上的妇女以及受教育程度较低的妇女的反馈。 BR决策援助（BRDA）将被确定。第3阶段将是DA的可用性和可行性试验测试，并考虑了BR的样本。该研究具有一个主要目标，两个次要目标。主要目的是评估决策援助的可用性和可行性，以帮助妇女决定进行BR。次要目的是检查BRDA的可接受性，并提供有关BRDA对BR知识，价值，决策冲突，准备，准备，BR兴趣和焦虑的影响的初步数据。