Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions
Identifieur interne : 000178 ( Istex/Corpus ); précédent : 000177; suivant : 000179Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions
Auteurs : Maria L. Jibaja Eiss ; Robert J. Volk ; Lois C. Friedman ; Thomas S. Granchi ; Nancy E. Neff ; Stephen J. Spann ; Emily K. Robinson ; Noriaki Aoki ; J. Robert BeckSource :
- Health Expectations [ 1369-6513 ] ; 2006-09.
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- KwdEn :
Abstract
Objective To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients.
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DOI: 10.1111/j.1369-7625.2006.00386.x
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Granchi</name><affiliation><mods:affiliation>Associate Professor, Department of Surgery</mods:affiliation></affiliation></author><author><name sortKey="Neff, Nancy E" sort="Neff, Nancy E" uniqKey="Neff N" first="Nancy E." last="Neff">Nancy E. Neff</name><affiliation><mods:affiliation>Clinical Assistant Professor, Department of Family and Community Medicine</mods:affiliation></affiliation></author><author><name sortKey="Spann, Stephen J" sort="Spann, Stephen J" uniqKey="Spann S" first="Stephen J." last="Spann">Stephen J. Spann</name><affiliation><mods:affiliation>Chairman/Professor, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX</mods:affiliation></affiliation></author><author><name sortKey="Robinson, Emily K" sort="Robinson, Emily K" uniqKey="Robinson E" first="Emily K." last="Robinson">Emily K. Robinson</name><affiliation><mods:affiliation>Assistant Professor Department of Surgery</mods:affiliation></affiliation></author><author><name sortKey="Aoki, Noriaki" sort="Aoki, Noriaki" uniqKey="Aoki N" first="Noriaki" last="Aoki">Noriaki Aoki</name><affiliation><mods:affiliation>Assistant Professor, School of Health Informations Science, The University of Texas Health Science Center, Houston, TX, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>President and Chief Information Officer, Center for Health Service, Outcomes Research and Development – Japan (CHORDJ), Tokyo, Japan</mods:affiliation></affiliation></author><author><name sortKey="Robert Beck, J" sort="Robert Beck, J" uniqKey="Robert Beck J" first="J." last="Robert Beck">J. Robert Beck</name><affiliation><mods:affiliation>Deputy Director, Population Service and Vice President for Information Services, Deputy Director, Population Sciences, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Health Expectations</title><idno type="ISSN">1369-6513</idno><idno type="eISSN">1369-7625</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2006-09">2006-09</date><biblScope unit="volume">9</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="218">218</biblScope><biblScope unit="page" to="231">231</biblScope></imprint><idno type="ISSN">1369-6513</idno></series><idno type="istex">571F56A56920549D5C1E52EA4F59D5B88F1E810C</idno><idno type="DOI">10.1111/j.1369-7625.2006.00386.x</idno><idno type="ArticleID">HEX386</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1369-6513</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>breast neoplasm</term><term>computer‐assisted</term><term>ethnic groups</term><term>lower literacy</term><term>mastectomy</term><term>values clarification exercises</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Maria L. Jibaja‐Weiss EdD</name><affiliations><json:string>Associate Professor, Department of Family and Community Medicine</json:string></affiliations></json:item><json:item><name>Robert J. Volk PhD</name><affiliations><json:string>Associate Professor, Department of Family and Community Medicine</json:string></affiliations></json:item><json:item><name>Lois C. Friedman PhD</name><affiliations><json:string>Associate Professor, Department of Family and Community Medicine</json:string><json:string>Associate Professor, Department of Psychiatry and Behavioral Sciences</json:string></affiliations></json:item><json:item><name>Thomas S. Granchi MD</name><affiliations><json:string>Associate Professor, Department of Surgery</json:string></affiliations></json:item><json:item><name>Nancy E. Neff MD</name><affiliations><json:string>Clinical Assistant Professor, Department of Family and Community Medicine</json:string></affiliations></json:item><json:item><name>Stephen J. Spann MD</name><affiliations><json:string>Chairman/Professor, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX</json:string></affiliations></json:item><json:item><name>Emily K. Robinson MD</name><affiliations><json:string>Assistant Professor Department of Surgery</json:string></affiliations></json:item><json:item><name>Noriaki Aoki MD</name><affiliations><json:string>Assistant Professor, School of Health Informations Science, The University of Texas Health Science Center, Houston, TX, USA</json:string><json:string>President and Chief Information Officer, Center for Health Service, Outcomes Research and Development – Japan (CHORDJ), Tokyo, Japan</json:string></affiliations></json:item><json:item><name>J. Robert Beck MD</name><affiliations><json:string>Deputy Director, Population Service and Vice President for Information Services, Deputy Director, Population Sciences, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>breast neoplasm</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>computer‐assisted</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ethnic groups</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>lower literacy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>mastectomy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>values clarification exercises</value></json:item></subject><articleId><json:string>HEX386</json:string></articleId><language><json:string>eng</json:string></language><abstract>Objective To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients.</abstract><qualityIndicators><score>7.94</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595.276 x 782.362 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1690</abstractCharCount><pdfWordCount>6490</pdfWordCount><pdfCharCount>42858</pdfCharCount><pdfPageCount>14</pdfPageCount><abstractWordCount>245</abstractWordCount></qualityIndicators><title>Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment 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Medicine</affiliation></author><author><persName><forename type="first">Lois C.</forename><surname>Friedman</surname></persName><roleName type="degree">PhD</roleName><affiliation>Associate Professor, Department of Family and Community Medicine</affiliation><affiliation>Associate Professor, Department of Psychiatry and Behavioral Sciences</affiliation></author><author><persName><forename type="first">Thomas S.</forename><surname>Granchi</surname></persName><roleName type="degree">MD</roleName><affiliation>Associate Professor, Department of Surgery</affiliation></author><author><persName><forename type="first">Nancy E.</forename><surname>Neff</surname></persName><roleName type="degree">MD</roleName><affiliation>Clinical Assistant Professor, Department of Family and Community Medicine</affiliation></author><author><persName><forename type="first">Stephen J.</forename><surname>Spann</surname></persName><roleName type="degree">MD</roleName><affiliation>Chairman/Professor, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX</affiliation></author><author><persName><forename type="first">Emily K.</forename><surname>Robinson</surname></persName><roleName type="degree">MD</roleName><affiliation>Assistant Professor Department of Surgery</affiliation></author><author><persName><forename type="first">Noriaki</forename><surname>Aoki</surname></persName><roleName type="degree">MD</roleName><affiliation>Assistant Professor, School of Health Informations Science, The University of Texas Health Science Center, Houston, TX, USA</affiliation><affiliation>President and Chief Information Officer, Center for Health Service, Outcomes Research and Development – Japan (CHORDJ), Tokyo, Japan</affiliation></author><author><persName><forename type="first">J.</forename><surname>Robert Beck</surname></persName><roleName type="degree">MD</roleName><affiliation>Deputy Director, Population Service and Vice President for Information Services, Deputy Director, Population Sciences, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, USA</affiliation></author></analytic><monogr><title level="j">Health Expectations</title><idno type="pISSN">1369-6513</idno><idno type="eISSN">1369-7625</idno><idno type="DOI">10.1111/(ISSN)1369-7625</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2006-09"></date><biblScope unit="volume">9</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="218">218</biblScope><biblScope unit="page" to="231">231</biblScope></imprint></monogr><idno type="istex">571F56A56920549D5C1E52EA4F59D5B88F1E810C</idno><idno type="DOI">10.1111/j.1369-7625.2006.00386.x</idno><idno type="ArticleID">HEX386</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2006</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>breast neoplasm</term></item><item><term>computer‐assisted</term></item><item><term>ethnic groups</term></item><item><term>lower literacy</term></item><item><term>mastectomy</term></item><item><term>values clarification exercises</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/571F56A56920549D5C1E52EA4F59D5B88F1E810C/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1369-7625</doi><issn type="print">1369-6513</issn><issn type="electronic">1369-7625</issn><idGroup><id type="product" value="HEX"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="HEALTH EXPECTATIONS">Health Expectations</title></titleGroup></publicationMeta><publicationMeta level="part" position="09003"><doi origin="wiley">10.1111/hex.2006.9.issue-3</doi><numberingGroup><numbering type="journalVolume" number="9">9</numbering><numbering type="journalIssue" number="3">3</numbering></numberingGroup><coverDate startDate="2006-09">September 2006</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="3" status="forIssue"><doi origin="wiley">10.1111/j.1369-7625.2006.00386.x</doi><idGroup><id type="unit" value="HEX386"></id></idGroup><countGroup><count type="pageTotal" number="14"></count></countGroup><titleGroup><title type="tocHeading1">Shared decision‐making</title></titleGroup><eventGroup><event type="firstOnline" date="2006-08-08"></event><event type="publishedOnlineFinalForm" date="2006-08-08"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-26"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-23"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="218">218</numbering><numbering type="pageLast" number="231">231</numbering></numberingGroup><correspondenceTo>Maria L. Jibaja‐Weiss
Department of Family and Community Medicine
Baylor College of Medicine
3701 Kirby Drive
Suite 600
Houston
TX 77098
USA
E‐mail: <email>mariaj@bcm.tmc.edu</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:HEX.HEX386.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory><b>Accepted for publication</b> 30 January 2006</unparsedEditorialHistory><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="5"></count></countGroup><titleGroup><title type="main">Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions</title><title type="shortAuthors">M L Jibaja‐Weiss <i>et al.</i></title><title type="short">Just‐in‐time values clarification</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Maria L.</givenNames><familyName>Jibaja‐Weiss</familyName><degrees>EdD</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Robert J.</givenNames><familyName>Volk</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1 #a2"><personName><givenNames>Lois C.</givenNames><familyName>Friedman</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>Thomas S.</givenNames><familyName>Granchi</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a6"><personName><givenNames>Nancy E.</givenNames><familyName>Neff</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a7"><personName><givenNames>Stephen J.</givenNames><familyName>Spann</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a4"><personName><givenNames>Emily K.</givenNames><familyName>Robinson</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a5 #a8"><personName><givenNames>Noriaki</givenNames><familyName>Aoki</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a9"><personName><givenNames>J.</givenNames><familyName>Robert Beck</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Associate Professor, Department of Family and Community Medicine</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation>Associate Professor, Department of Psychiatry and Behavioral Sciences</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Associate Professor, Department of Surgery</unparsedAffiliation></affiliation><affiliation xml:id="a6"><unparsedAffiliation>Clinical Assistant Professor, Department of Family and Community Medicine</unparsedAffiliation></affiliation><affiliation xml:id="a7"><unparsedAffiliation>Chairman/Professor, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>Assistant Professor Department of Surgery</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="US"><unparsedAffiliation>Assistant Professor, School of Health Informations Science, The University of Texas Health Science Center, Houston, TX, USA</unparsedAffiliation></affiliation><affiliation xml:id="a8" countryCode="JP"><unparsedAffiliation>President and Chief Information Officer, Center for Health Service, Outcomes Research and Development – Japan (CHORDJ), Tokyo, Japan</unparsedAffiliation></affiliation><affiliation xml:id="a9" countryCode="US"><unparsedAffiliation>Deputy Director, Population Service and Vice President for Information Services, Deputy Director, Population Sciences, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">breast neoplasm</keyword><keyword xml:id="k2">computer‐assisted</keyword><keyword xml:id="k3">ethnic groups</keyword><keyword xml:id="k4">lower literacy</keyword><keyword xml:id="k5">mastectomy</keyword><keyword xml:id="k6">values clarification exercises</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p><b>Objective </b> To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision.</p><p><b>Design </b> Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit.</p><p><b>Sample </b> Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals.</p><p><b>Intervention </b> A computerized decision aid that combines entertainment‐education (<i>edutainment</i>) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others.</p><p><b>Outcomes </b> Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS).</p><p><b>Results </b> Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made.</p><p><b>Conclusions </b> A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions</title></titleInfo><titleInfo type="abbreviated"><title>Just‐in‐time values clarification</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions</title></titleInfo><name type="personal"><namePart type="given">Maria L.</namePart><namePart type="family">Jibaja‐Weiss</namePart><namePart type="termsOfAddress">EdD</namePart><affiliation>Associate Professor, Department of Family and Community Medicine</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert J.</namePart><namePart type="family">Volk</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Associate Professor, Department of Family and Community Medicine</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lois C.</namePart><namePart type="family">Friedman</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Associate Professor, Department of Family and Community Medicine</affiliation><affiliation>Associate Professor, Department of Psychiatry and Behavioral Sciences</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas S.</namePart><namePart type="family">Granchi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Associate Professor, Department of Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nancy E.</namePart><namePart type="family">Neff</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Clinical Assistant Professor, Department of Family and Community Medicine</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephen J.</namePart><namePart type="family">Spann</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Chairman/Professor, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Emily K.</namePart><namePart type="family">Robinson</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Assistant Professor Department of Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Noriaki</namePart><namePart type="family">Aoki</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Assistant Professor, School of Health Informations Science, The University of Texas Health Science Center, Houston, TX, USA</affiliation><affiliation>President and Chief Information Officer, Center for Health Service, Outcomes Research and Development – Japan (CHORDJ), Tokyo, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Robert Beck</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Deputy Director, Population Service and Vice President for Information Services, Deputy Director, Population Sciences, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2006-09</dateIssued><edition>Accepted for publication 30 January 2006</edition><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">5</extent></physicalDescription><abstract lang="en">Objective To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients.</abstract><subject lang="en"><genre>Keywords</genre><topic>breast neoplasm</topic><topic>computer‐assisted</topic><topic>ethnic groups</topic><topic>lower literacy</topic><topic>mastectomy</topic><topic>values clarification exercises</topic></subject><relatedItem type="host"><titleInfo><title>Health Expectations</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1369-6513</identifier><identifier type="eISSN">1369-7625</identifier><identifier type="DOI">10.1111/(ISSN)1369-7625</identifier><identifier type="PublisherID">HEX</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>9</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>218</start><end>231</end><total>14</total></extent></part></relatedItem><identifier type="istex">571F56A56920549D5C1E52EA4F59D5B88F1E810C</identifier><identifier type="DOI">10.1111/j.1369-7625.2006.00386.x</identifier><identifier type="ArticleID">HEX386</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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