Project details

Background:

Patients want to be involved in the decision-making process regarding healthcare decisions (Brom et al., 2014; Grabbe et al., 2022). For appropriate participation, patients need awareness of their own desires and preferences as well as sufficient knowledge about all the advantages and disadvantages of respective medical interventions. Shared Decision-Making (SDM) offers a helpful concept for the collaborative decision-making process and thus for the participation of patients in the decision-making process.

In oncology, complex medical processes are encountered, accompanied by multifaceted and crucial decisions. Patients must be able to absorb and process complex information in emotionally taxing situations (Zwingmann et al., 2011). However, this increasingly requires patients to have more knowledge about their own condition and all available options (Westphalen et al., 2020). Therefore, it is essential to support patients in their participation in decision-making processes. There are various support options (Decision Support Interventions) aimed at helping patients engage successfully in medical decision-making processes and assisting them in making informed decisions together with their treatment team.Current research indicates that decision aids and decision coaching are effective ways to promote Shared Decision-Making (SDM) and support patients in decision-making (Berger-Höger et al., 2019; Stacey et al., 2017). However, there is a lack of sufficient decision support offerings and meaningful evaluation studies (Berger-Höger et al., 2020; Jull et al., 2021). Similarly, SDM and support options for patients are not universally implemented or integrated into healthcare structures in German-speaking regions (Berger-Höger et al., 2020; Steckelberg, 2016). Developing decision support tools with input from the target audience and considering potential barriers and facilitators for the implementation of decision coaching could be ways to address this issue.

Aim

The aim of this research project is the development and pilot testing of decision support tools for individuals seeking guidance in oncology. Due to the vulnerable nature of the target group, the main focus lies on the development and testing of the tools tailored to the target audience, with a focus on acceptance, comprehensibility, and usability. Additionally, barriers and facilitators for the implementation of the tools are to be identified. In the long term, the goal is to contribute to a uniform and widespread integration of Shared Decision-Making (SDM) and decision support tools into standard care based on the insights gained.

Methods

The development and pilot testing of decision support interventions are based on the MRC framework for the development and evaluation of complex interventions involving target groups and experts. Systematic literature searches are conducted to assess information needs and existing decision aids. For the pilot testing regarding feasibility, usability, and acceptance by the target groups, semi-structured individual interviews with the target groups are conducted and evaluated based on the structured qualitative content analysis method by Kuckartz (Kuckartz, 2018).Qualitative expert interviews with active and former decision coaches are conducted to assess barriers and facilitators. The focus is on their activities, work processes, structural and organizational conditions, and perceived acceptance.

Expected Results

The results are expected to identify facilitators and barriers for the acceptance and implementation of decision aids and decision coaching, thereby contributing to long-term decision support for patients.