cover image: Adaptation and Implementation of Pictorial Conversation Aids for Early-Stage Breast Cancer Surgery and Reconstruction: A Quality Improvement Study

Adaptation and Implementation of Pictorial Conversation Aids for Early-Stage Breast Cancer Surgery and Reconstruction: A Quality Improvement Study

4 Oct 2023

Purpose: After a diagnosis of early-stage breast cancer, women of lower socioeconomic position (SEP) report worse outcomes than women of higher SEP. A pictorial conversation aid was shown to improve decision outcomes in controlled contexts. No such intervention existed in France. In Phase 1, our aim was to adapt, for use in France, two pictorial conversation aids for breast cancer surgery and reconstruction. In Phase 2, our aim was to implement them in a regional cancer center serving a diverse population. Patients and methods: In phase 1, we used iterative qualitative methods to adapt the conversation aids with a convenience sample of patients and health professionals. In phase 2, we tested their implementation using PDSA cycles with volunteer surgeons. Results: In phase 1, we interviewed 10 health professionals and 5 patients to reach thematic data saturation. They found the conversation aids usable and very acceptable (especially patients) and suggested small changes to further simplify the layout and content (including a glossary). In phase 2, three surgeons started the first PDSA cycle, for 4 weeks. Only one additional surgeon agreed to take part in the second cycle. The third cycle was cancelled since no new surgeon agreed to take part. Time was a barrier for 2 out of 4 surgeons, potentially explaining the difficulty recruiting for the third cycle. The evaluation was otherwise positive. The surgeons found the conversation aids very useful during their consultations and all intended to continue using them in the future. Conclusion: It was possible to adapt, for use in France, pictorial conversation aids proven to be effective elsewhere. While the adapted conversation aids were deemed usable by health professionals and very acceptable to patients, their implementation using PDSA cycles proved slow.

Authors

Marie-Anne Durand, Marie Bannier, Marie-Anastasie Aim, Julien Mancini

Related Organizations

Aix-Marseille University
Dartmouth College
Bibliographic Reference
Marie-Anne Durand, Marie Bannier, Marie-Anastasie Aim, Julien Mancini. Adaptation and Implementation of Pictorial Conversation Aids for Early-Stage Breast Cancer Surgery and Reconstruction: A Quality Improvement Study. Patient Preference and Adherence, 2023, Volume17, pp.2463 - 2474. ⟨10.2147/ppa.s421695⟩. ⟨inserm-04302174⟩
DOI
https://doi.org/10.2147/ppa.s421695
HAL Collection
['INSERM - Institut national de la santé et de la recherche médicale', 'IRD - Institut de recherche pour le développement', 'Université Paul Sabatier - Toulouse III', 'Aix Marseille Université', "Santé Publique à l'Inserm", 'Laboratoire de psychologie sociale', "Sciences économique et sociales de la santé et traitement de l'information médicale - SESSTIM", 'Institut Créativité et Innovations Aix-Marseille', 'Laboratoire de Psychologie Sociale : contextes et régulation', 'Université Toulouse 3', 'Université Toulouse III / Toulouse INP', 'CERPOP']
HAL Identifier
4302174
Institution
['Université Toulouse III - Paul Sabatier', 'Institut National de la Santé et de la Recherche Médicale', 'Dartmouth College [Hanover]', 'Université de Lausanne = University of Lausanne', 'Institut Paoli-Calmettes', 'Aix Marseille Université', 'Institut de Recherche pour le Développement', 'Institut des sciences de la santé publique [Marseille]']
Laboratory
["Centre d'Epidémiologie et de Recherche en santé des POPulations", 'Centre universitaire de médecine générale et santé publique', 'Laboratoire de Psychologie Sociale', "Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale"]
Published in
France

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