Development of support material for health professionals who are implementing Shared Decision-making in breast cancer screening: validation using the Delphi technique

Abstract

BackgroundThe Literature is no report support material on Shared Decision-making applied to breast cancer screening that is intended for Spanish health professionals. The researcher created both a handbook and a guide for this topic using an adaption of the Three-talk model.ObjectiveA Delphi method will be used to reach an agreement among experts on the contents and design of a manual and guide, designed by the research team, and to be used by health professionals in the application of SDM in breast cancer screening.DesignA qualitative study. The content and design of the handbook and the guide was discussed by 20 experts. The Delphi techniques was in an online mode between July and October 2020 and researchers used Google forms in three rounds with open and closed questions. The criterion established for consensus was a coefficient of concordance (Cc) above 75, for questions using a Likert scale of 1–6—in which 1 meant ‘completely disagree’ and 6 ‘completely agree’—with a cut-off point equal to or higher than 4.ResultsParticipants considered the Three-talk model suitable for the screening context. The handbook sections and level of detail were considered satisfactory (Cc=90). The summary provided by the clinical practice guide was considered necessary (Cc=75), as it was the self-assessment tool for professionals (Cc=85). Content was added: addressing the limitations of the SDM model; extending the number of sample dialogues for health professionals; providing supplementary resources on using Patient Decisions aids and adding references on communication skills.Conclusions and applicationsThe first handbook and clinical practice guide providing unique SDM support material for health professionals have been developed. The handbook and guide are useful and innovative as supporting material for health professionals, but training strategies for SDM and a piloting plan for the use of materials are requested, in order to facilitate its implementation.

Establishment of an indicator framework for the transmission risk of the mountain-type zoonotic visceral leishmaniasis based on the Delphi-entropy weight method

“…The Delphi method is an anonymous questionnaire-based method that provides an objectivity and neutrality, as well as use of each expert's knowledge and experience. The method has a certain degree of subjectivity given that it is based on a set of integrated views, and practical and scientific support [ 21 ]. The entropy method is an objective method and mainly uses the characteristics of entropy to judge the dispersion degree of each indicator in the framework through the entropy value [ 22 ].…”

Shared decision-making in Spain in 2022: An updated revision of the current situation

“…New studies and research protocols have been published evaluating PtDAs for patients with rheumatoid arthritis [31], hip osteoarthritis [32], hormonal contraception [33], generalised anxiety [34] or the elderly with chronic diseases and polypharmacy [35]. Other studies have developed communication tools [36] and support materials aimed at facilitating the application of SDM by health professionals [37], but they did not assess their effectiveness. Two recent study protocols will assess the effectiveness of risk communication in breast cancer screening (DECIDO study) [38] and the integration of decision analysis in a decision tool for thromboprophylaxis during pregnancy (DASH-TOP) [39].…”

“…Likewise, the initiatives promoted by the professionals of the Women's Health Institute of the Hospital Universitario Clinico San Carlos de Madrid, have set up a SDM consultation with patients on the surgical treatment of breast cancer, whereby patients can assess the available surgical options together with the multidisciplinary medical team. At a research level, there are examples of training programs for patients and healthcare professionals including the component of SDM [37,56,57].…”

Implementation of Shared Decision-Making Within Internet Hospitals in China Based on Patients’ Needs: Feasibility Study and Content Analysis

“…The 3 main stages of doctor-patient SDM communication are selection talk, during which the doctor introduces the available treatment options or lets the patient know that there are more options; plan talk, during which the doctor elaborates on the advantages and disadvantages of the options available; and decision-making talk, during which the doctor discovers patient’s preferences. Afterward, they jointly choose the final treatment plan [ 21 ]. The doctors of the internet hospital basically grasp the patients’ preferences before consultation, and after consultation, they mainly conduct a plan talk and a decision-making talk according to the patient’s condition.…”