title: Qualitatively understanding patients' and health professionals' experiences of the BRECONDA breast reconstruction decision aid.
abstract: OBJECTIVE
  Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction.
  
  
  METHODS
  Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N = 36) and with their healthcare providers (N = 6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders.
  
  
  RESULTS
  Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey.
  
  
  CONCLUSIONS
  These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources.
authors.affiliation: Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.|Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Sydney, Australia.
authors.forename: Kerry A
authors.identifier: http://orcid.org/0000-0001-7780-6668
authors.initials: KA
authors.lastname: Sherman
authors.affiliation: Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: Laura-Kate
authors.initials: LK
authors.lastname: Shaw
authors.affiliation: Clinic for Surgery and Oncology & Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Jørgensen
authors.affiliation: Centre for Appearance Research, Faculty of Health & Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Harcourt
authors.affiliation: Psychological Sciences, University of California, Merced, CA, USA.|School of Psychology, The University of Auckland, Auckland, New Zealand.
authors.forename: Linda
authors.initials: L
authors.lastname: Cameron
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
authors.forename: John
authors.identifier: http://orcid.org/0000-0003-3208-3966
authors.initials: J
authors.lastname: Boyages
authors.affiliation: Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Sydney, Australia.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Elder
authors.affiliation: Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney Medical School, University of Sydney, Sydney, Australia.|Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, Australia.
authors.forename: Judy
authors.initials: J
authors.lastname: Kirk
authors.affiliation: Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Tucker
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D019928:Breast Implantation / Q000523:psychology* / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000601:surgery; D000073116:Cancer Survivors / Q000523:psychology*; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods / Q000523:psychology*; D008408:Mastectomy / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D036301:Qualitative Research; D012017:Referral and Consultation
keywords: BRCA; breast reconstruction; cancer; decision aid; oncology; user experience