Use and Evaluation of a Decision Aid for Patients with T1 Stage Breast Cancer

Purpose: Shared decision making using decision aids is becoming more common internationally as patients get more involved in healthcare decisions. In Germany decision aids are not yet widely used. A newly developed decision aid for women with T1 stage breast cancer contains extensive information on both breast-conserving therapy and breast removal to support the patient's decision-making process. We studied how patients and physicians evaluated the decision aid and the options for its use. Material and Methods: The decision aid was presented to patients with a primary diagnosis of breast cancer, members of a self-help group, physicians in specialised hospitals and gynaecologists in private practice. In a cross-sectional study, participants were asked to complete a questionnaire which included questions on the acceptance and implementation of the decision aid in daily routines. The data were analysed descriptively. Results: During the study 18 newly diagnosed patients, 42 members of a self-help group, I I physicians and psycho-oncologists of various hospitals and 150 gynaecologists in private practice participated. The participants evaluated the use of the decision aid positively. Both hospital-based physicians and gynaecologists in private practice should have a role in giving the decision aid to patients. The decision aid is best given to the patient in the period shortly after the diagnosis is confirmed and before the therapy plan is finalised, usually 4-14 days after diagnosis. Gynaecologists in private practice preferred giving the decision aid to patients at the second consultation. Conclusion: The decision aid was evaluated positively. Standardised procedures for use may be helpful to Support the regular utilisation of decision aids in a clinical setting. A translation of the decision aid into the languages spoken by the main immigrant groups in Germany should be considered.