Towards Informed Decisions on Breast Cancer Treatment: Development Process and Pilot Testing of a Decision Aid for Chinese Women

Background: in order to develop a patient decision aid that could support patients with breast cancer in making an informed decision about breast cancer treatment. Design: Using the Qualitative interview, the modified Delphi and pilot testing to confirm the contents of the breast cancer decision aid. Materials and Methods: The development included four stages: (i) Establishment of a multidisciplinary team; (ii) Needs assessment consisting of semi-structured interviews in patients; (iii) Creation of content, design and technical system; and (iv) Acceptability and usability was measured using the System Usability Scale (SUS). Results: From the needs assessment, five sub-themes were identified, captured by the two general themes of acceptability and feasibility. The decision aid that was developed contained three parts:(i) about breast cancer, (ii) surgical treatment options for breast cancer, (iii) Health popularization (including questions and tips for making sure patients obtained their desired disease knowledge in the decision), (iv) your preferences，(v) Extended care (including videos of patients entering and leaving, diet, exercise, etc.), and (vi) Background management. The decision aid was perceived to be informative, helpful and easy to use by patients. Conclusion: The content of decision aid was scientific and feasible, and most participants indicated that the decision aid was acceptable and comprehensive. Practice implications: Women want to be informed about breast cancer and the present decision aid is an acceptable and feasible form of decision support to facilitate discussions with doctors. Impacts: To solve the practical difficulties of breast cancer patients participating in treatment decision-making information needs, in the case of limited medical resources, to meet the diversified information needs of breast cancer patients participating in treatment decision-making, and to achieve timely, professional and personalized decision-making auxiliary information supply.