Qualitatively understanding patients' and health professionals' experiences of the BRECONDA breast reconstruction decision aid

Tucker, Katherine; Harcourt, Diana; Sherman, Kerry A.; Shaw, Laura Kate; Jorgensen, L; Cameron, Linda; Boyages, John; Elder, Elisabeth; Kirk, Judy

Abstract

Copyright © 2016 John Wiley & Sons, Ltd. Objective: Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction. Method: Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N=36) and with their healthcare providers (N=6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders. Results: Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey. Conclusion: These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources.

• Journal Article Type: Article
• Acceptance Date: Jan 1, 2017
• Online Publication Date: Jan 30, 2017
• Publication Date: Oct 1, 2017
• Deposit Date: Feb 2, 2017
• Publicly Available Date: Jan 30, 2018
• Journal: Psycho-Oncology
• Print ISSN: 1057-9249
• Electronic ISSN: 1099-1611
• Publisher: Wiley
• Peer Reviewed: Not Peer Reviewed
• Volume: 26
• Issue: 10
• Pages: 1618-1624
• DOI: https://doi.org/10.1002/pon.4346
• Keywords: BRCA, breast reconstruction, cancer, decision aid, oncology, user experience, visible difference
• Public URL: https://uwe-repository.worktribe.com/output/879380
• Publisher URL: http://dx.doi.org/10.1002/pon.4346
• Additional Information: Additional Information : This is the peer reviewed version of the following article: Harcourt, D., Sherman, K. A., Shaw, L., Jorgensen, L., Cameron, L., Boyages, J., Elder, E. and Kirk, J. (2017) Qualitatively understanding patients’ and health professionals’ experiences of the BRECONDA Breast Reconstruction Decision Aid. Psycho-Oncology. ISSN 1057-9249 [In Press], which has been published in final form at http://dx.doi.org/10.1002/pon.4346. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Feb 2, 2017