Search

Objective: Shared decision making (SDM) and use of patient decision aids (PtDAs) are key components in patient-centered care in relapsed ovarian cancer. This paper describes the development and implementation process of PtDAs into a clinical routine in three departments., Methods: Two PtDAs were developed in collaboration between patients and clinicians. Acceptability and usability of the PtDAs were tested on clinicians and patients using items from the internationally validated questionnaire "Preparation for Decision Making Scale"., Results: Ten patients and 15 clinicians participated in the study. Most patients indicated that PtDAs would be helpful as preparation for the decision-making process with the clinicians. Ten (75%) of the clinicians responded that the PtDAs helped the patients to understand the benefits and disadvantages of each treatment option. Generally, the clinicians indicated that they would use SDM if they had a PtDA tailored to the clinical situation., Conclusions: Two PtDAs were systematically developed, tested, and implemented thereby supporting an SDM intervention. The PtDAs are still in use at the participating departments., Innovation: This study was successful in reusing a generic template for a patient decision aid (PtDA) developed at one institution and implemented in two other institutions. This was guided by a well-described systematic development process for PtDAs., Competing Interests: The authors declare that there is no conflict of interest.

Objective: Patients with relapsed ovarian cancer are offered multiple treatment options. To match treatment with the individual patient's life situation and preferences, healthcare professionals can apply shared decision making (SDM) including patient decision aids (PtDAs).This study aimed to evaluate the implementation of two different PtDAs in consultations with patients suffering from relapsed ovarian cancer., Methods: We analyzed the following data before and after implementation of the PtDAs: 1) observed SDM using the OPTION instrument, 2) physician treatment recommendations, and 3) patients' and physicians' evaluations of SDM in consultations using the CollaboRATE, SDM-Q-9, and SDM-Q-Doc., Results: Significant improvement in observed SDM was found after the implementation ( p = 0.002). Improvement of SDM was detected in consultations conducted by physicians reporting more than two hours of SDM-training ( p < 0.001), but not when physicians reported less than two hours of SDM-training.No before/after differences in treatment recommendations and in patients' and physicians' evaluations were found., Conclusion: Implementation of PtDAs improved the level of observed SDM. Training of physicians in SDM is necessary for improved SDM practice., Innovation: Discussing oncological treatment options with the use of PtDAs is not standard practice in Denmark. The present study is one of the first Danish studies focusing on how to implement SDM and PtDAs in oncological consultations., Competing Interests: None., (© 2022 The Authors.)

Background and Purpose: Radiodermatitis is a well-known toxicity of radiotherapy and barrier film has been shown to reduce the severity of radiodermatitis. We have validated prior findings in a Danish cohort, using a similar barrier film and patient reported outcomes., Materials and Methods: 101 Danish breast cancer patients were included at three radiotherapy centres. Based on randomization either the lateral or medial part of their chest was covered by Mepitel film; making the patients their own control. The primary endpoint was patient reported symptoms and experience. A secondary endpoint was radiotherapy staff evaluation of dermatitis., Results: Within the skin area covered by film, the patients reported a statistical significant lower level of pain ( p < .001 ), itching ( p = 0.005 ), burning sensation ( p = 0.005 ) as well as edema (p = 0.017) and reduced sensitivity ( p < .001 ). Most patients (76%) would have preferred film on the entire treatment area ( p < 0.001 ) and Mepitel Film as a standard treatment option (84%) ( p < 0.001 ). Patients treated after mastectomy had a significantly lower severity of radiation-induced dermatitis with film at the end of RT compared to standard care ( p = 0.005 ). However, in the blinded staff evaluation, no significant differences were found at follow-up., Conclusions: Patients reported reduced symptoms from the skin with Mepitel Film and the majority would have preferred film as a standard offer to cover their entire treatment area. Especially women treated after mastectomy had a significantly lower level of radiodermatitis and preferred the film over standard care., (© 2018 The Authors.)

During radiotherapy, lung cancer patients commonly experience pain while swallowing (odynophagia) of food and drink. Observations from patient-centred nursing practice have been used to generate predictive models for odynophagia needing prescription pain medication during external beam lung radiotherapy for non-small cell and small-cell lung cancer. Three multivariate logistic models were evaluated in repeat cross-validation: a manual-stepwise model and two supervised machine learning models. Overall predictive performance was good. Correct classification rates ranged from 0.82 to 0.84, and areas under the receiver operator curve ranged from 0.83 to 0.85. Model sensitivity (range: 0.92-0.97) was higher than model specificity (range: 0.58-0.63). Further validation of the models in clinical context is required. A predictive model for pain medication for odynophagia prior to commencement of radiotherapy would support Radiotherapy Technologists Nurses (RTNs) in directing nursing interventions towards patients at risk., (© 2018 The Authors.)