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Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial

Sherman, Kerry A.; Shaw, Laura Kate E.; Winch, Caleb J.; Harcourt, Diana; Boyages, John; Cameron, Linda D.; Brown, Paul; Lam, Thomas; Elder, Elisabeth; French, James; Spillane, Andrew

Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial Thumbnail


Authors

Kerry A. Sherman

Laura Kate E. Shaw

Caleb J. Winch

John Boyages

Linda D. Cameron

Paul Brown

Thomas Lam

Elisabeth Elder

James French

Andrew Spillane



Abstract

Background: Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making.

Methods: Women (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret.

Results: Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction.

Conclusions: Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision.

Citation

Sherman, K. A., Shaw, L. K. E., Winch, C. J., Harcourt, D., Boyages, J., Cameron, L. D., …Spillane, A. (2016). Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial. Plastic and Reconstructive Surgery, 138(4), 592e-602e. https://doi.org/10.1097/PRS.0000000000002538

Journal Article Type Conference Paper
Acceptance Date Apr 15, 2016
Online Publication Date Oct 1, 2016
Publication Date Oct 1, 2016
Deposit Date May 4, 2016
Publicly Available Date Oct 1, 2017
Journal Plastic and Reconstructive Surgery
Print ISSN 0032-1052
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 138
Issue 4
Pages 592e-602e
DOI https://doi.org/10.1097/PRS.0000000000002538
Keywords mastectomy, breast reconstruction, BRECONDA, visible difference, body image
Public URL https://uwe-repository.worktribe.com/output/923199
Publisher URL http://dx.doi.org/10.1097/PRS.0000000000002538
Additional Information Additional Information : This is the accepted version of an article published in Plastic and Reconstructive Surgery. The final version can be found online at http://dx.doi.org/10.1097/PRS.0000000000002538

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