title: Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial.
abstract: We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer.
  
  
  
  Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups.
  
  
  
  At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P=0.021, Cohen's d =0.26) and Group 2 vs control (P=0.008, Cohen's d=0.40).
  
  
  
  The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer.
  
  
  
  The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.
authors.affiliation: Department of Nursing Informatics, St. Luke's International University Graduate School of Nursing Science, Tokyo, Japan; School of Nursing, The Jikei University, Tokyo, Japan. Electronic address: osakawakako@gmail.com.
authors.forename: Wakako
authors.initials: W
authors.lastname: Osaka
authors.affiliation: Department of Nursing Informatics, St. Luke's International University Graduate School of Nursing Science, Tokyo, Japan. Electronic address: nakayama@slcn.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D002755:Choice Behavior; D003220:Conflict, Psychological; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D033262:Narration; D010358:Patient Participation; D057240:Patient Preference; D017060:Patient Satisfaction; D018802:Patient-Centered Care
keywords: Breast cancer; Decision Support Techniques; Decisional conflict; Patient decision aids; Patient narratives; Patient-Centered Care; Preference-sensitive decision