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Developing a Decision Aid to Support Informed Choices for Newly Diagnosed Patients With Localized Prostate Cancer

Chabrera, Carolina MSN, RN; Font, Albert PhD; Caro, Mónica MD; Areal, Joan PhD; Zabalegui, Adelaida PhD, RN, FEANS

doi: 10.1097/NCC.0000000000000140
Articles: Online Only

Background: Decision aids (DAs) have been developed in several health disciplines to support decision making informed by evidence, such as the benefits and risks of different treatment options. Decision aids can improve the decision-making process by reducing decisional conflict and helping patients to participate in decision making.

Objective: The aim of this study was to design and develop a DA for treatment decision making in localized prostate cancer in Spain with regard to surgery, radiotherapy, or watchful waiting.

Interventions/Methods: We developed a DA based on the principles of the International Patient Decision Aid Standards Collaboration and according to the Ottawa Decision Support Framework. The structural development process involved DA developers, expert feedback, use of the Delphi method, and patient feedback. We conducted a pilot test on 34 men with localized prostate cancer.

Results: The DA is a structured booklet. According to the International Patient Decision Aid Standards checklist, the DA scored 22 of 27 points (81.48%). The development process section scored 22 of 24 points (91.6%), and the effectiveness of the decision-making process section scored 6 of 6 (100%). The clinical pilot test yielded positive feedback regarding the design, images, understandability, usability, explanations, and amount of information in the DA.

Conclusions: We developed a Spanish DA with a strong quality score to help patients make an informed choice regarding their prostate cancer treatment. Future research will assess the impact of the DA and its association with improved decision making.

Implications for Practice: This tool provides information about the risks and benefits of different treatment options and helps patients to understand the importance of their own values for informing treatment choices.

Author Affiliations: School of Health Science-TecnoCampus, Department of Nursing, University Pompeu Fabra, Mataró (Ms Chabrera); Department of Oncology, Catalan Institute of Oncology, Badalona (Ms Chabrera and Dr Font); Department of Radiation Oncology, Oncology Catalan Institute, Badalona (Dr Caro); Department of Urology, Germans Trias i Pujol University Hospital, Badalona (Dr Areal); and Hospital Clinic, Barcelona, Spain (Dr Zabalegui).

This project was supported by the Official Nursing College of Barcelona and Badalona Against Cancer Foundation.

The authors have no conflicts of interest to disclose.

Correspondence: Carolina Chabrera, MSN, RN, School of Health Science, TecnoCampus, Department of Nursing, Avinguda Ernest Lluch, 32 08302, Mataró, Spain (

Accepted for publication February 12, 2014.

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