ABSTRACT
OBJECTIVES: The aim of this study was to develop a breast cancer Patient Decision Aid (PDA), using a Health Technology Assessment (HTA) process, to assist patients in their choice of therapeutic options, and to promote shared decision making among patients, healthcare professionals, and other interested parties. METHODS: A systematic review (SR) was conducted of existing breast cancer patient Decision Aids encountered in the main scientific journal databases and on institutional Web sites that create PDAs, together with a Qualitative Research (QR) study, using semi-structured interviews and focus group with stakeholders (patients, family members, and health professionals), with the aim of developing a PDA for breast cancer. RESULTS: The SR shows that PDAs in breast cancer not only increase patient knowledge of the illness, leading to more realistic expectations of treatment outcomes, but also reduce passivity in the decision-making process and facilitate the appropriate choice of treatment options in accordance with patient medical and personal preferences. The analysis of QR shows that both breast cancer patients and healthcare professionals agree that surgery, adjuvant treatments, and breast reconstruction represent the most important decisions to be made. Worry, anxiety, optimism, and trust in healthcare professionals were determined as factors that most affected patients subjective experiences of the illness. This HTA was used as the basis for developing a PDA software program. CONCLUSIONS: The SR and QR used in the development of this PDA for breast cancer allowed patients to access information, gain additional knowledge of their illness, make shared treatment decisions, and gave healthcare professionals a deeper insight into patient experiences of the disease.
Subject(s)
Breast Neoplasms/diagnosis , Decision Support Techniques , Health Knowledge, Attitudes, Practice , Patient Participation , Technology Assessment, Biomedical/organization & administration , Adolescent , Adult , Aged , Female , Humans , Middle Aged , Patient Education as Topic , Socioeconomic Factors , Spain , Young AdultABSTRACT
Objetivo: El objetivo de este trabajo es conocer los estudios publicados es los diez últimos años sobre la utilización de herramientas de ayuda a la toma de decisiones en pacientes con cáncer colorrectal, en cualquiera de las fases de la enfermedad. Así como localizar las herramientas de ayuda a la toma de decisiones que están disponibles. Método: Se ha realizado una revisión de la literatura desde el 2000 hasta el 2010 en las bases MEDLINE, PsycINFO, EMBASE y Cochrane. Así como una búsqueda en páginas webs de distintas organizaciones para la localización de herramientas disponibles Resultados: Una vez realizada la selección de los artículos, se contó con 10 artículos que presentan herramientas, evalúan las preferencias de los pacientes a la hora de tomar decisiones, evalúan las estrategias de distribución de dichas herramientas o se evalúa la forma más eficaz de presentar la información en las herramientas. A través de la búsqueda realizada mediante las páginas webs de las organizaciones se encontraron seis herramientas propiamente dichas sobre el cribado de cáncer colorrectal. Conclusiones: cada vez es mayor el interés por implicar al paciente en la toma de decisiones con respecto al cáncer colorrectal. Para ello se hace necesaria la evaluación de las preferencias y valores de los pacientes y por eso el uso de herramientas de ayuda a la toma de decisiones puede ayudar a los profesionales en esa evaluación y a los pacientes, además de a tomar la decisión, a sentirse satisfecho con ella (AU)
Aim: The objective is to collect available patient decision aids (PDA) for colorectal cancer in any of the stages of the disease and to gather published studies about the use of these tools in the last ten years Methods: A systematic review (SR) of tools for Decision-making Aid in colorectal cancer was performed since year 2000. Search includes main databases (MEDLINE, PsycINFO, EMBASE, Cochrane) as well as websites of institutions working with PDAs to search available tools. Results: After the appraisal of the found articles, we finally selected 10 studies with PDA for colorectal cancer in which patients preferences in the decision making process, disseminating strategies of the tools or the way of presenting patient information were assessed. Through the websites of institutions working with PDAs we found six tools about screening in colorectal cancer. Conclusions: There is a growing interest to involve patients with colorectal cancer in the decision making process. To do so, its necessary to assess patients values and preferences and thats why PDAs are effective in helping both, professionals and patients. They are useful for professionals for this assessment process, and also for patients, not just to make a decision but also for being satisfied with the final decision (AU)
