Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial

Objective: We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. Methods: Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups. Results: At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P = 0.021, Cohen's d = 0.26) and Group 2 vs control (P = 0.008, Cohen's d = 0.40). Conclusion: The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer. Practice implications: The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer. (C) 2016 Elsevier Ireland Ltd. All rights reserved.