Patient Education and Counseling
Volume 86, Issue 2 , Pages 179-188, February 2012

Theory-based design and field-testing of an intervention to support women choosing surgery for breast cancer: BresDex☆

  • Stephanie Sivell

      Affiliations

    • Marie Curie Palliative Care Research Group, Wales Cancer Trials Unit, School of Medicine, Cardiff University, Cardiff, UK
    • Corresponding Author InformationCorresponding author at: Marie Curie Palliative Care Research Centre, Wales Cancer Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. Tel.: +44 029 2068 7198; fax: +44 029 2068 7501.
    • ,
  • William Marsh

      Affiliations

    • Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
    • ,
  • Adrian Edwards

      Affiliations

    • Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
    • ,
  • Antony S.R. Manstead

      Affiliations

    • School of Psychology, Cardiff University, Cardiff, UK
    • ,
  • Alison Clements

      Affiliations

    • Cancer Epidemiology Unit, University of Oxford, Oxford, UK
    • ,
  • Glyn Elwyn

      Affiliations

    • Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
    • ,
  • On Behalf of the BresDex group

Received 1 September 2010; received in revised form 7 March 2011; accepted 8 April 2011. published online 16 May 2011.

Abstract 

Objective

Design and undertake usability and field-testing evaluation of a theory-guided decision aid (BresDex) in supporting women choosing surgery for early breast cancer.

Methods

An extended Theory of Planned Behavior (TPB) and the Common Sense Model of Illness Representations (CSM) guided the design of BresDex. BresDex was evaluated and refined across 3 cycles by interviewing 6 women without personal history of breast cancer, 8 women with personal history of breast cancer who had completed treatment and 11 women newly diagnosed with breast cancer. Participants were interviewed for views on content, presentation (usability) and perceived usefulness towards deciding on treatment (utility). Framework analysis was used, guided by the extended TPB and the CSM.

Results

BresDex was positively received in content and presentation (usability). It appeared an effective support to decision-making and useful source for further information, particularly in clarifying attitudes, social norms and perceived behavioral control, and presenting consequences of decisions (utility).

Conclusion

This study illustrates the potential benefit of the extended TPB and CSM in designing a decision aid to support women choosing breast cancer surgery.

Practice implications

BresDex could provide decision-making support and serve as an additional source of information, to complement the care received from the clinical team.

Keywords: Decision aids, Decision support interventions, Theory of Planned Behavior, Common Sense Model of Illness Representations, Usability testing, Field-testing

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☆ Ethical approval for the study was granted by the Multi-Centre Research Ethics Committee for Wales and by the Medical/Dental Schools Research Ethics Committee, Cardiff University. Research governance was granted by Cardiff and Vales NHS Trust (now Cardiff and Vale University Health Board) and Velindre NHS Trust.

PII: S0738-3991(11)00202-3

doi:10.1016/j.pec.2011.04.014

Patient Education and Counseling
Volume 86, Issue 2 , Pages 179-188, February 2012

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