Effects of a web-based decision aid on breast cancer patients considering a breast reconstruction: a randomized controlled trial.

Purpose: Due to the variety of surgical methods, breast cancer patients may face dilemmas regarding decision-making. Web-based decision aids (WDAs) are interactive tools that help patients make informed decisions by meeting their needs both inside and outside the hospital, providing real-time decision assistance, and being more practical and convenient. Although the incidence of breast cancer ranks first among female cancers in China, studies focusing specifically on the use of WDAs in breast cancer patients have not been conducted in the country. The objective of this study was to determine the effects of WDAs on breast cancer patients considering a breast reconstruction.

Methods: A total of 70 patients with breast cancer were randomized, with 63 completing the whole trial. The control group used paper-based decision aids, which they could use freely in the ward to obtain health information support. The intervention group used web-based decision aids, including decision assessment, decision support, and decision evaluation, which they could use anytime and anywhere on their mobile phones. The study measured decision conflict, preferred decision-making roles, unmet needs, and decision satisfaction at baseline and before and after the intervention.

Results: No differences were found in the demographic and clinical features between the two groups. Compared with the control group, the intervention group had lower scores for the dimensions of decision support and decision effectiveness, decision uncertainty, total score of decision conflict and information needs, work and financial needs, access and continuity of care, coping, sharing and emotional needs, and total score of unmet information needs (P all < 0.05). Patients in the intervention group had a higher proportion of active and collaborative roles, higher scores in the information, deliberation, decision, and global satisfaction and confidence dimensions, and a higher total score for decision satisfaction (P all < 0.05).

Conclusion: WDAs are a convenient tool for promoting collaborative decision making, satisfying information needs, reducing decision conflict, and improving decision satisfaction. In addition, the development of WDAs avoids the limitations of region and time, and provides sufficient knowledge for patients to improve their medical experience.

Trial registration: Registration Number: ChiCTR2400092924 Dated: 26.11.2024.