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“They were aware of who I was as a person”: Patients’ and health professionals’ experiences of using the PEGASUS intervention to facilitate decision-making around breast reconstruction

Tollow, Philippa; Paraskeva, Nicole; Clarke, Alex; White, Paul; Powell, Jane; Cox, Danielle; Harcourt, Diana

“They were aware of who I was as a person”: Patients’ and health professionals’ experiences of using the PEGASUS intervention to facilitate decision-making around breast reconstruction Thumbnail


Authors

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Dr Pippa Howard Pippa.Tollow@uwe.ac.uk
Occasional Associate Lecturer - HAS - HSS

Alex Clarke

Paul White Paul.White@uwe.ac.uk
Associate Professor in Applied Statistics

Jane Powell Jane.Powell@uwe.ac.uk
Professor in Public Health Economics

Danielle Cox



Abstract

Objective: Many women choose to have breast reconstruction after mastectomy, however, decision-making can be difficult and expectations are often unmet. The PEGASUS intervention (Patient Expectations and Goals: Assisting Shared Understanding of Surgery) was developed to support shared decision-making by helping women and healthcare professionals to clarify and discuss their individual expectations around surgery. This study aimed to explore patients’ and health professionals’ experiences of using the intervention and its implementation. Methods: Forty interviews were conducted with participants in a large scale, multi-site trial of the effectiveness of PEGASUS, from ‘intervention’ (n=16) and ‘usual care’ groups (n=11), and healthcare professionals (n=13). Data was analysed using thematic analysis. Results: ‘Usual care’ participants described feeling overwhelmed in decision-making (‘bombarded’), often using their own research to break down information (‘process of elimination’). In contrast, intervention group participants described PEGASUS providing focus (‘focus amongst the frenetic’), and increased connection with clinicians (‘more than a number’). Healthcare professionals described increased focus on patient priorities (‘shifting focus’), but stressed the need for whole team buy-in (‘collective commitment’). Conclusions: The PEGASUS intervention offered a qualitatively different experience to individuals considering breast reconstruction, with potential to enhance patients’ and healthcare professionals’ feelings of shared decision-making and patient-centred care.

Citation

Tollow, P., Paraskeva, N., Clarke, A., White, P., Powell, J., Cox, D., & Harcourt, D. (in press). “They were aware of who I was as a person”: Patients’ and health professionals’ experiences of using the PEGASUS intervention to facilitate decision-making around breast reconstruction. European Journal of Cancer Care, https://doi.org/10.1111/ecc.13464

Journal Article Type Article
Acceptance Date May 5, 2021
Online Publication Date May 24, 2021
Deposit Date May 5, 2021
Publicly Available Date Jun 4, 2021
Journal European Journal of Cancer Care
Print ISSN 0961-5423
Electronic ISSN 1365-2354
Publisher Wiley
Peer Reviewed Peer Reviewed
Article Number e13464
DOI https://doi.org/10.1111/ecc.13464
Keywords breast cancer, breast reconstruction, mastectomy, patient-centred care, qualitative research, shared decision-making
Public URL https://uwe-repository.worktribe.com/output/7338682

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