"Insight into who you are as a human being": Perceptions of the Utility and Usability of a Values Assessment Tool (VAsT) for Women With Metastatic Breast Cancer.

Abstract

IntroductionWomen with metastatic breast cancer (mBC) often face complex treatment decisions that require careful consideration of values and priorities, which may be unique to each individual and evolve over the course of treatment. The patient-reported Values Assessment Tool (VAsT) was developed to help prioritize and communicate values to clinicians and care partners, thereby improving treatment decision-making. This study aimed to further refine the VAsT, assess perspectives on utility and usability of the VAsT, and evaluate the potential impact on communication between women with mBC, care partners, and clinicians who utilize the VAsT.MethodsA qualitative study using cognitive interview methodology was conducted. Qualitative cognitive interviews were conducted with seven women with mBC, three care partners, and four breast oncology clinicians. Participant feedback informed the refinement of the tool, and thematic analysis guided by Normalization Process Theory was conducted to understand the utility and usability of the VAsT among women with their clinicians and care partners.ResultsThe VAsT domains were confirmed (e.g., financial concerns of affording cancer care; minimize and manage side effects of treatment), and instructions and purpose were refined. Three themes related to the usability and communication with VAsT were identified: 1) Comprehension of values and meaningful use of the tool, 2) Usability and format of the VAsT, and 3) Communication and clinical utility of the VAsT.ConclusionFindings indicate there is variation in perspectives of how often the VAsT should be utilized over the course of treatment, which future research on the feasibility and efficacy of the VAsT will better elucidate. Women with mBC may use the VAsT to facilitate communication and build trust with clinicians, which is perceived to allow for higher-quality care and value-congruent treatment decisions.