Co-Creating and Refining a Values Assessment Tool (VAsT) for Women With Metastatic Breast Cancer.

Abstract

Background and aims: Patients with metastatic breast cancer (mBC) and their families often have differing perspectives on treatment goals. This highlights the need for systematically eliciting patients' and care partners' values to ensure values-aligned treatment decisions. This study aimed to inform the development of a values assessment tool to facilitate communication of priorities and preferences with oncology clinicians.

Methods: Two rounds of semi-structured interviews were conducted with women with mBC from the Southeastern and Northeastern U.S. Recruitment included at least 50% of participants identifying as African American/Black, Latinx, Asian, American Indian, or Native American.

Results: The initial round of 13 interviews yielded eight candidate domains. After confirmatory interviews with additional participants, the researchers identified nine final domains relevant to treatment decisions for mBC: desire not to appear sick; desire to help other women with breast cancer by participating in clinical research; financial concerns; living to care for a loved one; maintaining sexuality; maintaining quality of life; maximizing time away from medical appointments; minimizing and managing side effects; and slowing disease progression with an effective treatment.

Conclusion: Eliciting treatment decision values across multiple domains and effectively communicating them with clinicians is a crucial aspect of patient-centered care to align values with care goals. To help patients identify and express their values to clinicians, we are developing a values assessment tool specifically for mBC. Future research will pilot this tool to assess its impact on communication between clinicians and patients and health outcomes for women with mBC.