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Abstract：
BACKGROUND: To improve Shared decision-making (SDM) regarding personalized post-treatment surveillance, the Breast Cancer Surveillance Decision Aid (BCS-PtDA), integrating personalized risk information, was developed and implemented in eight hospitals. The aim of this mixed-methods study was to (1) assess the implementation and participation rates, (2) identify facilitators and barriers for use by health care professionals (HCPs), (3) quantify the observed level of SDM, and (4) evaluate risk communication and SDM application in consultations.
METHODS: Implementation and participation rates and patients\' BCS-PtDA use were calculated using hospital registry data and BCS-PtDA log data. HCPs\' perspective on facilitators and barriers were collected using the MIDI framework. Observed SDM levels in consultation transcripts were quantified using the OPTION-5 scale. Thematic analysis was performed to assess consultation content.
RESULTS: The average PtDA implementation and participation rates were, respectively, 26% and 61%. HCPs reported that the PtDA supported choice awareness. Reported barriers for implementation were mainly increased workload and a lack of perceived benefits. The consultation analysis (n = 64) showed patients were offered a choice, but deliberation was lacking. Risk communication was generally adequate.
CONCLUSIONS: When the BCS-PtDA was used, patients were clearly given a choice regarding their post-treatment surveillance, but information provision and SDM application can be improved.
METHODS: Implementation and participation rates and patients\' BCS-PtDA use were calculated using hospital registry data and BCS-PtDA log data. HCPs\' perspective on facilitators and barriers were collected using the MIDI framework. Observed SDM levels in consultation transcripts were quantified using the OPTION-5 scale. Thematic analysis was performed to assess consultation content.
RESULTS: The average PtDA implementation and participation rates were, respectively, 26% and 61%. HCPs reported that the PtDA supported choice awareness. Reported barriers for implementation were mainly increased workload and a lack of perceived benefits. The consultation analysis (n = 64) showed patients were offered a choice, but deliberation was lacking. Risk communication was generally adequate.
CONCLUSIONS: When the BCS-PtDA was used, patients were clearly given a choice regarding their post-treatment surveillance, but information provision and SDM application can be improved.
摘要：
背景：为了改善有关个性化治疗后监测的共享决策（SDM），乳腺癌监测决策援助（BCS-PtDA），整合个性化风险信息，在八家医院开发和实施。这项混合方法研究的目的是(1)评估实施和参与率，(2)确定医疗保健专业人员(HCP)使用的促进者和障碍，(3)量化SDM的观测水平，(4)评估咨询中的风险沟通和SDM应用。
方法：使用医院注册数据和BCS-PtDA日志数据计算实施和参与率以及患者的BCS-PtDA使用情况。使用MIDI框架收集了HCP对促进者和障碍的看法。使用OPTION-5量表量化咨询转录物中观察到的SDM水平。进行主题分析以评估咨询内容。
结果：PtDA的平均执行率和参与率为，分别,26%和61%。HCP报告说，PtDA支持选择意识。报告的执行障碍主要是工作量增加和缺乏感知的好处。咨询分析(n=64)显示，患者获得了选择，但是缺乏深思熟虑。风险沟通通常是足够的。
结论：当使用BCS-PtDA时，患者显然可以选择治疗后的监测，但是可以改进信息提供和SDM应用。
方法：使用医院注册数据和BCS-PtDA日志数据计算实施和参与率以及患者的BCS-PtDA使用情况。使用MIDI框架收集了HCP对促进者和障碍的看法。使用OPTION-5量表量化咨询转录物中观察到的SDM水平。进行主题分析以评估咨询内容。
结果：PtDA的平均执行率和参与率为，分别,26%和61%。HCP报告说，PtDA支持选择意识。报告的执行障碍主要是工作量增加和缺乏感知的好处。咨询分析(n=64)显示，患者获得了选择，但是缺乏深思熟虑。风险沟通通常是足够的。
结论：当使用BCS-PtDA时，患者显然可以选择治疗后的监测，但是可以改进信息提供和SDM应用。
