title: Design and Focus Test of a Preconsultation Decision Aid for Breast Cancer Reconstruction Patients: A Quality Improvement Initiative.
abstract: OBJECTIVE
  To design, develop, and evaluate via focus group a preconsultation decision aid to improve patient satisfaction for breast reconstruction.
  
  
  METHODS
  The design of the decision aid was based on perceived patient needs, literature, existing decision aids, and current standard of breast cancer reconstruction treatment and consultation at Stanford. Our decision aid was designed to (1) reducing fear of the unknown in patients via providing a knowledge base that they can rely on, (2) helping patients identify their key breast reconstruction concerns, (3) addressing common patient concerns, (4) providing a framework to help patients identify the treatment option that may be right for them, and (5) promoting shared decision making. Physicians were consulted on the decision aid, following which a focus group was conducted for patient feedback.
  
  
  RESULTS
  Interviewed patients (n = 12) were supportive of the decision aid initiative. Participants were especially pleased with the side-by-side comparison of surgical options and the parsimonious way information was represented. All patients before undergoing reconstruction (n = 3) requested the decision guide to reference at home. All interviewed patients believed information level was "about right."
  
  
  CONCLUSIONS
  Decision aid was well received by patients in the focus group. As the initiative is for quality improvement, we saw no need to further delay the distribution of the decision aid. A pilot study will be conducted to evaluate whether our decision aid has an effect on patients' decision regret, stress, and anxiety.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Hui
authors.affiliation: Division of Plastic and Reconstructive Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiang X
authors.initials: XX
authors.lastname: Liu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif.
authors.forename: Anna
authors.initials: A
authors.lastname: Luan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif.
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Lee
keywords: breast reconstruction; clinical outcomes; decision aid; patient satisfaction; regret