Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol
Introduction Advanced oral cancer and its ensuing treatment engenders significant morbidity and mortality. Patients are often elderly with significant comorbidities. Toxicities associated with surgical resection can be devastating and they are often highlighted by patients as impactful. Given the po...
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e036969.full |
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| author | David Goldstein John R de Almeida Rosemary Martino Douglas B Chepeha David Forner Paul Hong Martin Corsten Valeria E Rac Andrew G Shuman Anna M Sawka Jonathan C Irish Dale H Brown S Mark Taylor Patrick J Gullane Jonathan R Trites Ralph Gilbert Matthew H Rigby Jolie Ringash |
| author_facet | David Goldstein John R de Almeida Rosemary Martino Douglas B Chepeha David Forner Paul Hong Martin Corsten Valeria E Rac Andrew G Shuman Anna M Sawka Jonathan C Irish Dale H Brown S Mark Taylor Patrick J Gullane Jonathan R Trites Ralph Gilbert Matthew H Rigby Jolie Ringash |
| author_sort | David Goldstein |
| collection | DOAJ |
| description | Introduction Advanced oral cancer and its ensuing treatment engenders significant morbidity and mortality. Patients are often elderly with significant comorbidities. Toxicities associated with surgical resection can be devastating and they are often highlighted by patients as impactful. Given the potential for suboptimal oncological and functional outcomes in this vulnerable patient population, promotion and performance of shared decision making (SDM) is crucial.Decision aids (DAs) are useful instruments for facilitating the SDM process by presenting patients with up-to-date evidence regarding risks, benefits and the possible postoperative course. Importantly, DAs also help elicit and clarify patient values and preferences. The use of DAs in cancer treatment has been shown to reduce decisional conflict and increase SDM. No DAs for oral cavity cancer have yet been developed.This study endeavours to answer the question: Is there a patient or surgeon driven need for development and implementation of a DA for adult patients considering major surgery for oral cancer?Methods and analysis This study is the first step in a multiphase investigation of SDM during major head and neck surgery. It is a multi-institutional convergent parallel mixed-methods needs assessment study. Patients and surgeon dyads will be recruited to complete questionnaires related to their perception of the SDM process (nine-item Shared Decision-Making Questionnaire, SDM-Q-9 and SDM-Q-Doc) and to take part in semistructured interviews. Patients will also complete questionnaires examining decisional self-efficacy (Ottawa Decision Self-Efficacy Scale) and decisional conflict (Decisional Conflict Scale). Questionnaires will be completed at time of recruitment and will be used to assess the current level of SDM, self-efficacy and conflict in this setting. Thematic analysis will be used to analyse transcripts of interviews. Quantitative and qualitative components of the study will be integrated through triangulation, with matrix developed to promote visualisation of the data.Ethics and Dissemination This study has been approved by the research ethics boards of the Nova Scotia Health Authority (Halifax, Nova Scotia) and the University Health Network (Toronto, Ontario). Dissemination to clinicians will be through traditional approaches and creation of a head and neck cancer SDM website. Dissemination to patients will include a section within the website, patient advocacy groups and postings within clinical environments. |
| format | Article |
| id | doaj-art-562e5c8e5a104a03978e9cbbde3d26e2 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-562e5c8e5a104a03978e9cbbde3d26e22024-11-26T00:15:09ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-036969Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocolDavid Goldstein0John R de Almeida1Rosemary Martino2Douglas B Chepeha3David Forner4Paul Hong5Martin Corsten6Valeria E Rac7Andrew G Shuman8Anna M Sawka9Jonathan C Irish10Dale H Brown11S Mark Taylor12Patrick J Gullane13Jonathan R Trites14Ralph Gilbert15Matthew H Rigby16Jolie Ringash175 UNSW Prince of Wales Clinical School, Randwick, New South Wales, Australia2 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada4 Department of Speech Language Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada7 Otolaryngology -- Head & Neck Surgery, University Health Network, Toronto, Ontario, Canada1 Otolaryngology -- Head & Neck Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada1 Otolaryngology -- Head & Neck Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada1 Otolaryngology -- Head & Neck Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, CanadaInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada6 Otolaryngology -- Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA8 Endocrinology, University Health Network, Toronto, Ontario, Canada7 Otolaryngology -- Head & Neck Surgery, University Health Network, Toronto, Ontario, Canada7 Otolaryngology -- Head & Neck Surgery, University Health Network, Toronto, Ontario, Canada1 Otolaryngology -- Head & Neck Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada7 Otolaryngology -- Head & Neck Surgery, University Health Network, Toronto, Ontario, Canada1 Otolaryngology -- Head & Neck Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada7 Otolaryngology -- Head & Neck Surgery, University Health Network, Toronto, Ontario, Canada1 Otolaryngology -- Head & Neck Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada2 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, CanadaIntroduction Advanced oral cancer and its ensuing treatment engenders significant morbidity and mortality. Patients are often elderly with significant comorbidities. Toxicities associated with surgical resection can be devastating and they are often highlighted by patients as impactful. Given the potential for suboptimal oncological and functional outcomes in this vulnerable patient population, promotion and performance of shared decision making (SDM) is crucial.Decision aids (DAs) are useful instruments for facilitating the SDM process by presenting patients with up-to-date evidence regarding risks, benefits and the possible postoperative course. Importantly, DAs also help elicit and clarify patient values and preferences. The use of DAs in cancer treatment has been shown to reduce decisional conflict and increase SDM. No DAs for oral cavity cancer have yet been developed.This study endeavours to answer the question: Is there a patient or surgeon driven need for development and implementation of a DA for adult patients considering major surgery for oral cancer?Methods and analysis This study is the first step in a multiphase investigation of SDM during major head and neck surgery. It is a multi-institutional convergent parallel mixed-methods needs assessment study. Patients and surgeon dyads will be recruited to complete questionnaires related to their perception of the SDM process (nine-item Shared Decision-Making Questionnaire, SDM-Q-9 and SDM-Q-Doc) and to take part in semistructured interviews. Patients will also complete questionnaires examining decisional self-efficacy (Ottawa Decision Self-Efficacy Scale) and decisional conflict (Decisional Conflict Scale). Questionnaires will be completed at time of recruitment and will be used to assess the current level of SDM, self-efficacy and conflict in this setting. Thematic analysis will be used to analyse transcripts of interviews. Quantitative and qualitative components of the study will be integrated through triangulation, with matrix developed to promote visualisation of the data.Ethics and Dissemination This study has been approved by the research ethics boards of the Nova Scotia Health Authority (Halifax, Nova Scotia) and the University Health Network (Toronto, Ontario). Dissemination to clinicians will be through traditional approaches and creation of a head and neck cancer SDM website. Dissemination to patients will include a section within the website, patient advocacy groups and postings within clinical environments.https://bmjopen.bmj.com/content/10/11/e036969.full |
| spellingShingle | David Goldstein John R de Almeida Rosemary Martino Douglas B Chepeha David Forner Paul Hong Martin Corsten Valeria E Rac Andrew G Shuman Anna M Sawka Jonathan C Irish Dale H Brown S Mark Taylor Patrick J Gullane Jonathan R Trites Ralph Gilbert Matthew H Rigby Jolie Ringash Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol BMJ Open |
| title | Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol |
| title_full | Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol |
| title_fullStr | Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol |
| title_full_unstemmed | Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol |
| title_short | Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol |
| title_sort | needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction a mixed methods study protocol |
| url | https://bmjopen.bmj.com/content/10/11/e036969.full |
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