Evaluation of a Rectal Cancer Patient Decision Aid and the Factors Influencing its Implementability in Clinical Practice

Abstract

A rectal cancer patient decision aid (PtDA) was developed to help patients consider the benefits and risks associated with two surgical treatment options. The current thesis evaluated the effect of the PtDA on patients and explored surgeons’ perceived factors influencing the implementation of the PtDA in clinical practice. Using a before and after study design, the PtDA was given to patients with rectal cancer at a cancer assessment center. Based on 28 patients recruited, the PtDA improved their knowledge, lowered decisional conflict, and patients rated it acceptable. A cross-sectional survey was mailed to 105 Canadian colorectal surgeons and 49 responded (46.7% response rate). Commonly perceived barriers were time constraint, need for multiple visits, and additional personnel and facilitators were simplifying the decision aid, adding to content, and translating to other languages. The PtDA improved patient decision making outcomes but requires interventions to overcome surgeon-identified barriers to use in clinical practice.