Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients

A three-arm randomized controlled trial

Wakako Osaka, Kazuhiro Nakayama

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. Methods Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups. Results At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P = 0.021, Cohen's d  = 0.26) and Group 2 vs control (P = 0.008, Cohen's d = 0.40). Conclusion The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer. Practice implications The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.

Original languageEnglish
Pages (from-to)550-562
Number of pages13
JournalPatient Education and Counseling
Volume100
Issue number3
DOIs
Publication statusPublished - 2017 Mar 1
Externally publishedYes

Fingerprint

Decision Support Techniques
Randomized Controlled Trials
Breast Neoplasms
Control Groups

Keywords

  • Breast cancer
  • Decision Support Techniques
  • Decisional conflict
  • Patient decision aids
  • Patient narratives
  • Patient-Centered Care
  • Preference-sensitive decision

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial",
abstract = "Objective We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. Methods Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups. Results At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P = 0.021, Cohen's d  = 0.26) and Group 2 vs control (P = 0.008, Cohen's d = 0.40). Conclusion The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer. Practice implications The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.",
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N2 - Objective We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. Methods Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups. Results At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P = 0.021, Cohen's d  = 0.26) and Group 2 vs control (P = 0.008, Cohen's d = 0.40). Conclusion The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer. Practice implications The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.

AB - Objective We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. Methods Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups. Results At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P = 0.021, Cohen's d  = 0.26) and Group 2 vs control (P = 0.008, Cohen's d = 0.40). Conclusion The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer. Practice implications The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.

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