Development of a patient decision aid (PDA)for patients undergoing breast reconstructive surgery: towards shared decision-making.

BACKGROUND: The study developed a decision aid (DA) for Malaysian breast cancer survivors considering breast reconstruction post-mastectomy. The DA aims to improve patient engagement and decision-making, addressing the lack of resources for non-Western populations and providing women with the knowledge and confidence needed for personalized and satisfactory treatment decisions. METHODS: The DA utilized Kelly's framework for the development and testing of our decision aid for women considering breast reconstruction post-mastectomy. The DA was developed and evaluated in two phases. The first phase included the development of the DA with input and review by a multidisciplinary panel of experts and healthcare professionals. The second phase involved assessment of the finalized PDA for feasibility and acceptability within the target demographic, utilizing pre- and post-exposure questionnaires to gauge its impact on participants' decision-making processes. RESULTS: The phase 1 results of the study indicate that the DA has been positively accepted, with the majority of health experts and patients rating the provided information as good or excellent. The results also showed decisional conflict decreased significantly (p < 0.001), and knowledge increased significantly (p < 0.001) among participants from before using the DA to 2-3 weeks after its use. CONCLUSIONS: Our DA is feasible and acceptable to women considering breast reconstruction. Furthermore, the DA effectively reduces decisional conflict and increases knowledge about breast reconstruction. The DA is an appropriate tool to be used in addition to standard care in women considering breast reconstruction.