D B Raphael1, J A Ter Stege2, N S Russell3, L J Boersma4, T van der Weijden5. 1. Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Family Medicine, CAPHRI School for Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Radiotherapy, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands. Electronic address: d.raphael@nki.nl. 2. Department of Psychosocial Research and Epidemiology Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands. Electronic address: j.t.stege@nki.nl. 3. Department of Radiotherapy, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands. Electronic address: n.russell@nki.nl. 4. Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: liesbeth.boersma@maastro.nl. 5. Department of Family Medicine, CAPHRI School for Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands. Electronic address: trudy.vanderweijden@maastrichtuniversity.nl.
Abstract
BACKGROUND AND AIM: There is increased attention for shared decision making (SDM) when deciding on radiotherapy for selected patients with Stage 0-2 breast cancer. This study aimed to explore patients' and health care professionals' experiences, decisional attributes and needs as input for the development of a patient decision aid to facilitate SDM. METHODS: Qualitative semi-structured interviews were held with fifteen breast cancer patients, being confronted with a radiotherapy decision one month to eight years earlier. Another fifteen interviews were held with professionals specialized in breast cancer care. Interviews were transcribed verbatim and independently coded by two researchers, who agreed upon relevant issues. RESULTS: Most patients made their decision by weighing the advantages of radiotherapy, i.e. comparing the decrease in recurrence risk with and without radiotherapy, and disadvantages, i.e. possible side effects. Patients and professionals agreed that recurrence risks should be communicated, but not on how to deal with uncertainty. There was wide variation in which, and how, side effects were explained by professionals. The most common side effects mentioned by both patients and professionals were skin toxicity, fatigue and breast deformity. CONCLUSION: Patients and professionals appeared to agree on what type of attributes should be communicated during SDM on radiotherapy, but how this should be done is up for discussion. To ensure the patient's voice these attributes and needs need to be incorporated in the risk communication and value elicitation part of the patient decision aid. The format in which the attributes are communicated should be critically evaluated.
BACKGROUND AND AIM: There is increased attention for shared decision making (SDM) when deciding on radiotherapy for selected patients with Stage 0-2 breast cancer. This study aimed to explore patients' and health care professionals' experiences, decisional attributes and needs as input for the development of a patient decision aid to facilitate SDM. METHODS: Qualitative semi-structured interviews were held with fifteen breast cancerpatients, being confronted with a radiotherapy decision one month to eight years earlier. Another fifteen interviews were held with professionals specialized in breast cancer care. Interviews were transcribed verbatim and independently coded by two researchers, who agreed upon relevant issues. RESULTS: Most patients made their decision by weighing the advantages of radiotherapy, i.e. comparing the decrease in recurrence risk with and without radiotherapy, and disadvantages, i.e. possible side effects. Patients and professionals agreed that recurrence risks should be communicated, but not on how to deal with uncertainty. There was wide variation in which, and how, side effects were explained by professionals. The most common side effects mentioned by both patients and professionals were skin toxicity, fatigue and breast deformity. CONCLUSION:Patients and professionals appeared to agree on what type of attributes should be communicated during SDM on radiotherapy, but how this should be done is up for discussion. To ensure the patient's voice these attributes and needs need to be incorporated in the risk communication and value elicitation part of the patient decision aid. The format in which the attributes are communicated should be critically evaluated.
Authors: D B Raphael; N S Russell; B Winkens; J M Immink; P G Westhoff; M C Stenfert Kroese; M R Stam; N Bijker; C M J van Gestel; T van der Weijden; L J Boersma Journal: Tech Innov Patient Support Radiat Oncol Date: 2021-08-29
Authors: D B Raphael; N S Russell; J M Immink; P G Westhoff; M C Stenfert Kroese; M R Stam; L M van Maurik; H J G D van den Bongard; J H Maduro; M G A Sattler; T van der Weijden; L J Boersma Journal: Breast Date: 2020-04-06 Impact factor: 4.380
Authors: D B Raphael Daniela; N S Russell; E van Werkhoven; J M Immink; D P G Westhoff; M C Stenfert Kroese; M R Stam; L M van Maurik; C M J van Gestel; T van der Weijden; L J Boersma Journal: Breast Cancer Res Treat Date: 2020-10-24 Impact factor: 4.872