Pilot evaluation of a decision aid for Chinese women considering breast cancer surgery for localized breast cancer

Abstract

BACKGROUND: We developed and piloted adecision aid (DA) booklet for Chinese women withlocalized breast cancer (BC) considering breastcancer surgery. This is probably the first DAdesigned specifically for non-Caucasian cancerpatients. The current study tested the acceptabilityof the DA booklet to assist Chinese women facingbreast cancer treatment decision-making (TDM).METHOD: Chinese women diagnosed with loca-lized breast cancer were invited to evaluate the DAbooklet. A total of 95 women received the DAbooklet at the end of their initial diagnosticconsultation. Questionnaires evaluating attitudestoward the DA booklet, patients’ understanding ofBC treatment and preference for decision involve-ment were completed four days after the initialconsultation. The questionnaire was completedusing a face-to-face interview. RESULTS: Mostwomen (88%) had read/partly read the DA book-let; 73% found it useful in choosing BC surgery.Most found that the DA was easy to understand(89%), facilitated their understanding of informa-tion obtained from their surgeon (87%), and wasnot anxiety provoking (77%). Women found theDA eased TDM (84%). Women who read (mean7.17) or partly read (mean 4.71) the DA had abetter understanding of BC than those who did not read the booklet (mean 2.91, po.001). Womenpreferring passive participation were less likely toread the booklet compared to those preferringactive/shared decision making participation(p 5 .025). CONCLUSIONS: Our findings suggestthat the DA booklet is acceptable to Chinesewomen deciding for breast cancer surgery. Con-sistent with previous studies, the DA bookletincreased Chinese women’s knowledge of BC andits treatment. RESEARCH IMPLICATIONS: TheDA booklet has been revised to make it moreparsimonious and enhance its clarity, particularlyfor sub-literate women. The revised DA booklet isbeing evaluated in a randomized controlled trial.CLINICAL IMPLICATIONS: Previous studiesshowed difficulties in treatment decision making(TDM) leads to persistent psychological distressamong Chinese women with BC. If effective inimproving health outcomes, the DA could be usedin facilitate TDM, thereby minimizing subsequentpsychological distress. ACKNOWLEDGEMENTOF FUNDING: This study was funded by HongKong Cancer Fund.