Article
Development and evaluation of a patient empowerment intervention to support shared decision-making in cancer care
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Published: | February 12, 2020 |
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Background/research question: Many cancer patients want active engagement in treatment decision-making. Interventions like Ask 3 Questions (A3Q) encourage patients to ask questions during clinical encounters and strengthen their abilities to engage in decision-making processes. A3Q was developed in Australia and different versions of the A3Q intervention were used in implementation programs around the globe. So far, A3Q was not available in German. Aims of this study were to develop a German version of the intervention and to assess its feasibility and acceptance in German routine cancer care.
Methods: Different English versions of the A3Q intervention were translated into German following a team translation protocol. Comprehensibility and relevance were tested via cognitive interviews with n=10 cancer patients. Acceptance and feasibility were assessed in focus groups and interviews with cancer patients, physicians and nurses. Focus groups and interviews were analyzed using qualitative content analysis.
Results: In cognitive interviews, cancer patients of different age (49.0 years ± 11.27), gender (f=5, m=5), years with disease (4.8 years ± 3.55), and health literacy levels participated. Comparison and testing of different A3Q versions led to a revised version that was well understood and seen as relevant for cancer patients. We conducted focus groups and interviews with n=24 cancer patients of different cancer entities, n=15 nurses and n=6 physicians. A3Q was perceived as a helpful tool to encourage patients to ask more questions in clinical encounters. It was also seen as a guideline for physicians in supporting to remember to answer important questions. Barriers and facilitators of the use of A3Q in routine care will be presented at the conference.
Conclusion: This study provides a German version of the A3Q intervention. Preliminary results suggest that A3Q could be a helpful instrument to empower patients to play an active role in decision-making processes. Barriers and facilitators must be analyzed carefully to understand how to best implement the A3Q intervention in German routine care.
Competing interests: P. Hahlweg gave one scientific presentation on shared decision-making during a lunch symposium, for which she received compensation and travel compensation from GlaxoSmithKline GmbH in 2018. A. Lindig, W. Frerichs and I. Scholl declared to not have any competing interests.