Shared decision‐making: Applying a person‐centered approach to tailored breast reconstruction information provides high satisfaction across a variety of breast reconstruction options. Issue 7 (11th July 2014)

• Record Type: Journal Article
• Authors: Temple‐Oberle, Claire; Ayeni, Omodole; Webb, Carmen; Bettger‐Hahn, Margo; Ayeni, Olubukunola; Mychailyshyn, Nadia
• Is Part Of: Journal of surgical oncology. Volume 110:Issue 7(2014:Dec. 01)
• Page Start: 796
• Page End: 800
• Publication Date: 2014-07-11
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23721
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23721-sec-0001" sec-type="section"> <title>Background</title> <p>A person‐centered approach to co‐decision‐making using tailored information respects each woman's preferences and may heighten breast reconstruction satisfaction.</p> </sec> <sec id="jso23721-sec-0002" sec-type="section"> <title>Methods</title> <p>Women seeking breast reconstruction underwent initial and follow‐up consultations wherein suitable options were discussed, and take‐away material, balanced website links, and access to a nurse specialist and peer volunteers was provided. After reconstruction, the BRECON‐31<sup>©</sup> was administered and analyzed in three groups: autologous, alloplastic, and latissimus dorsi (LD)/implant. BRECON‐31<sup>©</sup> subscale scores were compared between the groups, and multiple regression used to determine if the type of reconstruction independently predicted satisfaction.</p> </sec> <sec id="jso23721-sec-0003" sec-type="section"> <title>Results</title> <p>One hundred twenty three of 176 (70%) women completed the questionnaire (43% autologous, 47% alloplastic, and 10% LD/implant reconstructions). The LD/implant group had a low rate of immediate reconstruction (8.3%, <italic>P</italic> = 0.04), and the highest rate of chemotherapy (91.7%, <italic>P</italic> = 0.002) and radiation (100%, <italic>P</italic> = 0.003). The alloplastic group had a high rate of bilateral reconstruction (86.8%, <italic>P</italic> = 0.01). All groups scored well on the self‐image, arm concerns, intimacy, satisfaction, and expectations subscales. All groups scored moderately on the self‐consciousness, appearance, and nipple subscales. The autologous group scored the lowest on recovery (51 vs. 68 and 65, <italic>P</italic> < 0.0001) and only moderately well on the abdomen subscale (67). Multiple regression analysis showed that satisfaction was not driven by type of reconstruction (<italic>P</italic> > 0.05).</p> </sec> <sec id="jso23721-sec-0004" sec-type="section"> <title>Conclusion</title> <p>High satisfaction can be achieved using a person‐centered approach by providing detailed information, appreciating each woman's unique features, and tailoring the reconstruction plan to the individual. Recovery remains a particular challenge, especially for women undergoing autologous reconstruction. <italic>J. Surg. Oncol. 2014 110:796–800</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>