Improving the Quality of Decision Making in Breast Cancer: Consultation Planning Template and Consultation Recording Template

Karen R. Sepucha

Jeffrey K. Belkora

Caryn Aviv

Stephanie Mutchnick

Laura J. Esserman

ONF 2003, 30(1), 99-106. DOI: 10.1188/03.ONF.99-106

Purpose/Objectives: To describe two templates that can be used to improve the quality of breast cancer treatment decisions.

Data Sources: Case study, survey of current users, three clinical trials.

Findings: Clinical applications of the Consultation Planning Template and Consultation Recording Template vary across organizations. Clinical trials have demonstrated that the templates can improve the quality of decisions, the quality of communication between patients and providers, and satisfaction.

Conclusions: The templates can be adapted to different clinical settings and can improve the quality of treatment decisions.

Implications for Nursing: Nurses often provide the majority of education and coaching for patients making decisions. As patients' demands for involvement in decision making increase, nurses need practical tools to help patients participate. The templates are practical tools that nurses can use to help patients make better decisions.

Jump to a section

    References

    Belkora, J. (1997). Mindful collaboration: Prospect mapping as an action research approach to planning for medical consultations. Doctoral dissertation, Stanford University, Stanford, CT. Dissertation Abstracts International, 58(09), 4703. (UMI No. 9810081)

    Berland, G.K., Elliott, M.N., Morales, L.S., Algazy, J.I., Kravitz, R.L., Broder, M.S., et al. (2001). Health information on the Internet: Accessibility, quality, and readability in English and Spanish. JAMA, 285, 2612-2621.

    Chapman, G.B., Elstein, A.S., & Hughes, K.K. (1995). Effects of patient education on decisions about breast cancer treatments: A preliminary report. Medical Decision Making, 15, 231-239.

    Cimprich, B., & Ronis, D.L. (2001). Attention and symptom distress in women with and without breast cancer. Nursing Research, 50, 86-94.

    Doyle, M., & Straus, D. (1993). The new interaction method: How to make meetings work. New York: Berkeley Publishing Group.

    Frosch, D.L., Kaplan, R.M., & Felitti, V. (2001). The evaluation of two methods to facilitate shared decision making for men considering the prostate-specific antigen test. Journal of General Internal Medicine, 16, 391-398.

    Goel, V., Sawka, C.A., Thiel, E.C., Gort, E.H., & O'Connor, A.M. (2001). Randomized trial of a patient decision aid for choice of surgical treatment for breast cancer. Medical Decision Making, 21, 1-6.

    Gramlich, E.P., & Waitzfelder, B.E. (1998). Interactive video assists in clinical decision making. Methods of Information in Medicine, 37, 201-205.

    Hammond, J., Keeney, R., & Raiffa, H. (1998). Smart choices: A guide to making better decisions. Cambridge, MA: Harvard Business School Press.

    Howard, R.A., & Matheson, J.E. (Eds.). (1989). Readings on the principles and applications of decision analysis. (Vols. I & II). Menlo Park, CA: Strategic Decisions Press.

    Laughlin, J. (1999, January 2). Tagging along: Getting an education by taking notes for ER doctors, premed "scribes" get a jump on medical school. The Washington Post, pp. B3.

    Lipkin, M.J., Putnam, S.M., & Lazare, A. (Eds.). (1995). The medical interview: Clinical care, education, and research. New York: Springer-Verlag.

    Llewellyn-Thomas, H.A. (1995). Patients' health-care decision making: A framework for descriptive and experimental investigations. Medical Decision Making, 15, 101-106.

    Lobb, E.A., Butow, P.N., Kenny, D.T., & Tattersall, M.H. (1999). Communicating prognosis in early breast cancer: Do women understand the language used? Medical Journal of Australia, 171, 290-294.

    Marvel, M.K., Epstein, R.M., Flowers, K., & Beckman, H.B. (1999). Soliciting the patient's agenda: Have we improved? JAMA, 281, 283-287.

    Maslin, A.M., Baum, M., Walker, J.S., A'Hern, R., & Prouse, A. (1998). Using an interactive video disk in breast cancer patient support. Nursing Times, 94(44), 52-55.

    O'Connor, A., Stacey, D., Rovner, D., Holmes-Rovner, M., Tetroe, J., Llewellyn-Thomas, H., et al. (2001). Decision aids for people facing health treatment or screening decisions [Cochrane Review]. The Cochrane Library, 3. Oxford, England: Update Software.

    O'Connor, A.M., Fiset, V., DeGrasse, C., Graham, I.D., Evans, W., Stacey, D. et al. (1999). Decision aids for patients considering options affecting cancer outcomes: Evidence of efficacy and policy implications. Journal of the National Cancer Institute. Monographs, 25, 67-80.

    O'Connor, A.M., Rostom, A., Fiset, V., Tetroe, J., Entwistle, V., Llewellyn-Thomas, H., et al. (1999). Decision aids for patients facing health treatment or screening decisions: Systematic review. BMJ, 319, 731-734.

    Onel, E., Hamond, C., Wasson, J.H., Berlin, B.B., Ely, M.G., Laudone, V.P., et al. (1998). Assessment of the feasibility and impact of shared decision making in prostate cancer. Urology, 51, 63-66.

    Rees, C.E., & Bath, P.A. (2001). Information-seeking behaviors of women with breast cancer. Oncology Nursing Forum, 28, 899-907.

    Roter, D.L., & Hall, J.A. (1987). Physician's interviewing styles and medical information obtained from patients. Journal of General Internal Medicine, 2, 325-329.

    Sainio, C., Eriksson, E., & Lauri, S. (2001). Patient participation in decision making about care. Cancer Nursing, 24, 172-179.

    Schaefer, K.M., Ladd, E., Gergits, M.A., & Gyauch, L. (2001). Backing and forthing: The process of decision making by women considering participation in a breast cancer prevention trial. Oncology Nursing Forum, 28, 703-709.

    Sepucha, K. (1999). Consultation recording methods to facilitate collaborative decision-making in breast cancer. Unpublished doctoral dissertation, Stanford University, Stanford, CA. Dissertation Abstracts International, 60(04), 1511. (UMI No. 9924548)

    Sepucha, K.R., Belkora, J.K., Mutchnick, S., & Esserman, L.J. (2002). Consultation planning to help patients prepare for medical consultations: Effect on communication and satisfaction for patients and physicians. Journal of Clinical Oncology, 20, 2695-2700.

    Sepucha, K.R., Belkora, J.K., Tripathy, D., & Esserman, L.J. (2000). Building bridges between physicians and patients: Results of a pilot study examining new tools for collaborative decision making in breast cancer. Journal of Clinical Oncology, 18, 1230-1238.

    Skinn, B., & Stacey, D. (1994). Establishing an integrated framework for documentation: Use of a self-reporting health history and outpatient oncology record. Oncology Nursing Forum, 21, 1557-1566.

    Steginga, S., Occhipinti, S., Wilson, K., & Dunn, J. (1998). Domains of distress: The experience of breast cancer in Australia. Oncology Nursing Forum, 25, 1063-1070.

    Suchman, A.L., Markakis, K., Beckman, H.B., & Frankel, R. (1997). A model of empathic communication in the medical interview. JAMA, 277, 678-682.

    Weed, L.L. (1968). Medical records that guide and teach. New England Journal of Medicine, 278, 652-657.

    Whelan, T., Levine, M., Gafni, A., Sanders, K., Willan, A., Mirsky, D., et al. (1999). Mastectomy or lumpectomy? Helping women make informed choices. Journal of Clinical Oncology, 17, 1727-1735.

    White, J., Levinson, W., & Roter, D. (1994). "Oh, by the way…": The closing moments of the medical visit. Journal of General Internal Medicine, 9(1), 24-28.