Decision aids for surgical treatment of early stage breast cancer: A narrative review of the literature

Objective: To review and critique the published empirical research on decision aids for women actually facing surgical treatment of early stage breast cancer, synthesize findings across studies related to outcomes of decision aids use with specific attention to the influence of system and client characteristics, and identify opportunities for further research. Methods: A systematic and reproducible search was carried out to identify studies evaluating decision aids for women making breast cancer surgical treatment decisions. All included studies were appraised. Results: Most studies evaluated the outcomes of decision aids use in terms of final treatment decisions, patients' knowledge of treatment options, anxiety, decisional conflict, satisfaction and quality of life. Included studies varied in design, measures used to assess effectiveness, format of the aids, patient populations and clinical settings. Studies yielded mixed results related to the effect of the decision aids on the outcomes measured. Conclusion: Despite the mixed findings of the studies, some support exists for the use of decision aids with women diagnosed with early stage breast cancer. Practice implications: To ensure successful implementation of decision aids in clinical practice, healthcare providers should be educated on their use. Greater allocation of time, space and access to decision aids is also needed.