The “Preparation for Shared Decision-Making” Tool for Women With Advanced Breast Cancer: Qualitative Validation Study

Background The range of decisions and considerations that women with advanced breast cancer (ABC) face can be overwhelming and difficult to manage. Research shows that most patients prefer a shared decision-making (SDM) approach as it provides them with the opportunity to be actively involved in their treatment decisions. The current engagement of these patients in their clinical decisions is suboptimal. Moreover, implementing SDM into routine clinical care can be challenging as patients may not always feel adequately prepared or may not expect to be involved in the decision-making process. Objective Avalere Health developed the Preparation for Shared Decision-Making (PFSDM) tool to help patients with ABC feel prepared to communicate with their clinicians and engage in decision making aligned with their preferences. The goal of this study was to validate the tool for its acceptability and usability among this patient population. Methods We interviewed a diverse group of women with ABC (N=30). Interviews were audiorecorded, transcribed, and double coded by using NVivo. We assessed 8 themes to understand the acceptability and usability of the tool. Results Interviewees expressed that the tool was acceptable for preparing patients for decision making and would be useful for helping patients know what to expect in their care journey. Interviewees also provided useful comments to improve the tool. Conclusions This validation study confirms the acceptability and usability of the PFSDM tool for women with ABC. Future research should assess the feasibility of the tool’s implementation in the clinical workflow and its impact on patient outcomes.

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The “Preparation for Shared Decision-Making” Tool for Women With Advanced Breast Cancer: Qualitative Validation Study (Preprint)

10.2196/preprints.16511 ◽

2019 ◽

Author(s):

Domitilla Masi ◽

Amalia Elvira Gomez-Rexrode ◽

Rina Bardin ◽

Joshua Seidman

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Advanced Breast Cancer ◽

Shared Decision Making ◽

Validation Study ◽

Clinical Care ◽

Advanced Breast ◽

Future Research ◽

Shared Decision ◽

Clinical Workflow

BACKGROUND The range of decisions and considerations that women with advanced breast cancer (ABC) face can be overwhelming and difficult to manage. Research shows that most patients prefer a shared decision-making (SDM) approach as it provides them with the opportunity to be actively involved in their treatment decisions. The current engagement of these patients in their clinical decisions is suboptimal. Moreover, implementing SDM into routine clinical care can be challenging as patients may not always feel adequately prepared or may not expect to be involved in the decision-making process. OBJECTIVE Avalere Health developed the <italic>Preparation for Shared Decision-Making</italic> (PFSDM) tool to help patients with ABC feel prepared to communicate with their clinicians and engage in decision making aligned with their preferences. The goal of this study was to validate the tool for its acceptability and usability among this patient population. METHODS We interviewed a diverse group of women with ABC (N=30). Interviews were audiorecorded, transcribed, and double coded by using NVivo. We assessed 8 themes to understand the acceptability and usability of the tool. RESULTS Interviewees expressed that the tool was acceptable for preparing patients for decision making and would be useful for helping patients know what to expect in their care journey. Interviewees also provided useful comments to improve the tool. CONCLUSIONS This validation study confirms the acceptability and usability of the PFSDM tool for women with ABC. Future research should assess the feasibility of the tool’s implementation in the clinical workflow and its impact on patient outcomes.

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The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

10.31234/osf.io/f84cq ◽

2020 ◽

Author(s):

Martina Bientzle ◽

Marie Eggeling ◽

Simone Korger ◽

Joachim Kimmerle

Keyword(s):

Decision Making ◽

Medical Students ◽

Shared Decision Making ◽

Medical Training ◽

Controlled Trial ◽

Future Research ◽

Shared Decision ◽

Randomized Controlled ◽

Information Text ◽

The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

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Breast Cancer Pathways Program Impact on Patient Shared Decision Making and Experience in Academic and Community Practice

Case Medical Research ◽

10.31525/ct1-nct04297384 ◽

2020 ◽

Author(s):

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Shared Decision Making ◽

Community Practice ◽

Shared Decision ◽

Program Impact ◽

Cancer Pathways

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Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042128 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2128

Author(s):

Marta Maes-Carballo ◽

Manuel Martín-Díaz ◽

Luciano Mignini ◽

Khalid Saeed Khan ◽

Rubén Trigueros ◽

...

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Shared Decision Making ◽

Health Professionals ◽

Cross Sectional Study ◽

Shared Decision ◽

Online Questionnaire ◽

Cross Sectional ◽

Professional Societies ◽

New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

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Erratum to: Does a tailored, multilevel implementation programme help clinicians to apply shared decision-making in breast cancer care? A before-after study

BJS Open ◽

10.1093/bjsopen/zrab008 ◽

2021 ◽

Vol 5 (3) ◽

Author(s):

H van Veenendaal ◽

H R Voogdt-Pruis ◽

D T Ubbink ◽

C G J M Hilders

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Shared Decision Making ◽

Cancer Care ◽

Shared Decision ◽

Breast Cancer Care ◽

Implementation Programme

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Shared decision making for supporting women’s decisions about breast cancer screening

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013822 ◽

2020 ◽

Author(s):

Paula Riganti ◽

M. Victoria Ruiz Yanzi ◽

Camila Micaela Escobar Liquitay ◽

Karin S Kopitowski ◽

Juan VA Franco

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Shared Decision Making ◽

Shared Decision

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EFFECTS OF A SHARED DECISION MAKING INTERVENTION FOR OLDER ADULTS WITH CHRONIC CONDITIONS: AN OBSERVATIONAL STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.1090 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S296-S297

Author(s):

Ruth E Pel-Littel ◽

Bianca Buurman ◽

Marjolein van de Pol ◽

Linda Tulner ◽

Mirella Minkman ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Observational Study ◽

Shared Decision Making ◽

Chronic Conditions ◽

Decisional Conflict ◽

Future Research ◽

Multiple Chronic Conditions ◽

Shared Decision ◽

Perceived Involvement

Abstract Shared decision making (SDM) in older patients is more complex when multiple chronic conditions (MCC) have to be taken into account. The aim of this research is to explore the effect of the evidence based implementation intervention SDMMCC on (1) the preferred and perceived participation (2) decisional conflict and (3) actual SDM during consultations. 216 outpatients participated in a video observational study. The intervention existed of a SDM training for geriatricians and a preparatory tool for patients. Consultations were videotaped and coded with the OPTIONMCC. Pre- and post-consultation questionnaires were completed. Participation was measured by the Patients’ perceived Involvement in Care Scale (PICS). Decisional conflict was measured by the Decisional Conflict Scale (DCS). The patients mean age was 77 years, 56% was female. The preparatory tool was completed by 56 older adults (52%), of which 64% rated the tool as positive. The preparatory tool was used in 12% of the consultations. The mean overall OPTIONMCC score showed no significant changes on the level of SDM(39.3 vs 39.3 P0.98), however there were significant improvements on discussing goals and options on sub-items of the scale. There were no significant differences found in the match on preferred and perceived participation (86.5% vs 85.0% P 0.595) or in decisional conflict (22.7 vs 22.9 P0.630). The limited use of the preparatory tool could have biased the effect of the intervention. In future research more attention must be paid towards the implementation of preparatory tools, not only among patients but also among geriatricians.

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Shared decision-making for breast cancer patients

Early Breast Cancer ◽

10.1201/b13937-32 ◽

2013 ◽

pp. 311-321

Author(s):

Catharine Clay ◽

Alice Andrews ◽

Dale Vidal

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Cancer Patients ◽

Shared Decision Making ◽

Shared Decision ◽

Breast Cancer Patients

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Multidisciplinary teams caring for people with variations of sex characteristics: a scoping review

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001257 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001257

Author(s):

Martin Gramc ◽

Jürg Streuli ◽

Eva de Clercq

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Scoping Review ◽

Ethical Principles ◽

Care Process ◽

Future Research ◽

Medical Professionals ◽

Sex Characteristics ◽

Multidisciplinary Teams ◽

Shared Decision

BackgroundIn 2006 the Chicago consensus statement on the management of people with variations of sex characteristics (VSC) acknowledged the importance of a multidisciplinary team (MDT) approach. The consensus update from 2016 reinforced the call for multidisciplinary collaborations between medical professionals, parents and support groups, and proposed guidelines to improve shared decision making and patient-centred care embedded in ethical principles of self-determination and child participation. But there is little evidence that successfully MDTs have been implemented in clinical practice.Methods and aimsA scoping review was conducted to identify studies that address the collaboration and decision making process of MDTs providing care of people with VSC to identify ideal and actual (1) team composition; (2) models of collaboration and (3) ethical principles that MDTs follow. Six databases were systematically searched: CINAHIL, Medline, Psychinfo, Scopus, Socindex and Web of Science. No restriction was placed on the type of methodology used in the studies. To frame the research, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used.ResultsThe MDTs in the literature include mainly medical professionals: endocrinologists, urologists and surgeons. The collaboration among medical professionals in MDTs lacks cooperation as one team member sets the tasks of the team while each professional works separately. Despite the importance of psycho-social support the involvement of psychologists remains secondary. The implementation of ethical principles tends to exclude people with VSC.ConclusionThe care of people with VSC described in the papers is medically oriented as the team members are mainly medical professionals working separately. MDT tend to exclude people with VSC despite references to shared decision making processes and informed consent. There was no mention of adult care and lack of inclusion of patient’s perspective in the care process. The future research should do more empirical research of MDTs.

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