BACKGROUND: The primary objective of this study was to develop a decision aid which would encourage and assist patients to become involved in treatment decision making, and help clinicians to objectively educate patients about the benefits and risks of adjuvant chemotherapy for breast cancer. A secondary objective was to investigate the factors influencing this treatment decision-making process for women when choosing between adriamycin and cyclophosphamide (AC) versus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy. METHODS: An educational visual instrument called a Decision Board was developed consisting of written and graphical material. The Decision Board displays general information about chemotherapy and detailed information about each chemotherapy regimen, including the schedule and side effects, and was presented to patients with a scripted standardized oral explanation. The instrument was evaluated in 46 premenopausal women newly diagnosed with node-positive breast cancer. Following presentation of the board, the patients were given a take home version to review and asked to return 1-2 weeks later with a decision. During the second visit each patient was asked to complete a questionnaire regarding demographics, learning and comprehension, treatment preference, and factors influencing their decision. RESULTS: Recall of information was acceptable (> or = 80%). The Decision Board was found helpful by all, but the level of difficulty with decision making was variable. Out of 46 women, 23 women chose AC, 21 chose CMF, and two chose no treatment. The major factors affecting treatment preference were related to the impact on quality of life, the length of therapy, and the side effects, in particular, vomiting and alopecia. CONCLUSIONS: The Decision Board appears to be a valuable educational tool that enables patients to become well-informed and directly involved in their treatment decisions.
BACKGROUND: The primary objective of this study was to develop a decision aid which would encourage and assist patients to become involved in treatment decision making, and help clinicians to objectively educate patients about the benefits and risks of adjuvant chemotherapy for breast cancer. A secondary objective was to investigate the factors influencing this treatment decision-making process for women when choosing between adriamycin and cyclophosphamide (AC) versus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy. METHODS: An educational visual instrument called a Decision Board was developed consisting of written and graphical material. The Decision Board displays general information about chemotherapy and detailed information about each chemotherapy regimen, including the schedule and side effects, and was presented to patients with a scripted standardized oral explanation. The instrument was evaluated in 46 premenopausal women newly diagnosed with node-positive breast cancer. Following presentation of the board, the patients were given a take home version to review and asked to return 1-2 weeks later with a decision. During the second visit each patient was asked to complete a questionnaire regarding demographics, learning and comprehension, treatment preference, and factors influencing their decision. RESULTS: Recall of information was acceptable (> or = 80%). The Decision Board was found helpful by all, but the level of difficulty with decision making was variable. Out of 46 women, 23 women chose AC, 21 chose CMF, and two chose no treatment. The major factors affecting treatment preference were related to the impact on quality of life, the length of therapy, and the side effects, in particular, vomiting and alopecia. CONCLUSIONS: The Decision Board appears to be a valuable educational tool that enables patients to become well-informed and directly involved in their treatment decisions.
Authors: Deb Feldman-Stewart; Sarah Brennenstuhl; Kathryn McIssac; Joan Austoker; Agathe Charvet; Paul Hewitson; Karen R Sepucha; Tim Whelan Journal: Health Expect Date: 2007-03 Impact factor: 3.377
Authors: A M Stiggelbout; S J T Jansen; W Otten; M C M Baas-Thijssen; H van Slooten; C J H van de Velde Journal: Support Care Cancer Date: 2006-11-21 Impact factor: 3.603
Authors: Kimberly S Chiew; Heather Shepherd; Janette Vardy; Martin H N Tattersall; Phyllis N Butow; Natasha B Leighl Journal: Health Expect Date: 2008-03 Impact factor: 3.377
Authors: Anna M Sawka; David P Goldstein; James D Brierley; Richard W Tsang; Lorne Rotstein; Shereen Ezzat; Sharon Straus; Susan R George; Susan Abbey; Gary Rodin; Mary Ann O'Brien; Amiram Gafni; Lehana Thabane; Jeannette Goguen; Asima Naeem; Lilian Magalhaes Journal: PLoS One Date: 2009-01-14 Impact factor: 3.240
Authors: Rhodri Evans; Glyn Elwyn; Adrian Edwards; Eila Watson; Joan Austoker; Richard Grol Journal: J Med Internet Res Date: 2007-07-13 Impact factor: 5.428