Background
Preference sensitive decision making and decision aids (DAs)
The decision
Chapter # | Titles and subtitles |
---|---|
1. |
Can I still achieve a pregnancy (after my treatment for breast cancer)?
|
• Chemotherapy | |
• Hormonal therapy | |
• Other treatments | |
2. |
What can I do now to be able to have children later?
|
• Wait and see | |
• Cryopreservation of embryos | |
• Cryopreservation of ovarian tissue | |
• Cryopreservation of oocytes | |
3. |
What if I cannot achieve a pregnancy later?
|
• No children | |
• Oocyte donation | |
• Adoption | |
• Foster parenting | |
4. |
Background information
|
• Fertility | |
• Pregnancy and breast cancer | |
• Genetics and breast cancer | |
5. |
Deciding about fertility preservation
|
• What is important to me? | |
- Wait and see | |
- Cryopreservation of embryos | |
- Cryopreservation of ovarian tissue | |
• Question prompt list |
The current research
Experiment 1
Methods experiment 1
Study design
Participants
Procedure
Measurements
Emotion induction
Statistics
Power calculation
Results experiment 1
Participants and socio-demographic characteristics
DA with information only (VCE-) | DA with information plus VCE (VCE+) | Primary analysis (A vs B) | Secondary analysis (A vs C vs D) | |||||
---|---|---|---|---|---|---|---|---|
Total group VCE- (N = 70) | Total group VCE + (N = 70) |
VCE used (VCE++) (n = 33)
|
VCE not used (VCE + -) (n = 37)
| F-(condition) or χ2-value | Post hoc | F-(condition) or χ2-value | Post hoc | |
A | B |
C
|
D
| |||||
Age, mean (SD) | 20.7 (3.3) | 20.9 (3.5) |
20.4 (3.5)
|
21.6 (3.5)
| NS | NS | ||
Child wish, yes, n (%) | 56 (80) | 64 (91) |
34 (91)
|
30 (91)
| 6.9* | A < B | 7.17* | A < D = C |
Children, yes, n (%) | 3 (4) | - |
-
|
-
| - | - | ||
Partner, yes, n (%) | 34 (49) | 42 (60) |
24 (65)
|
18 (55)
| NS | NS | ||
Decisional conflict
| ||||||||
Total DCS, M (SD) | 40.9 (11.6) | 43.6 (14.2) |
37.9 (15.7)
|
48.6 (10.6)
| NS | 6.4** | A = C < D | |
Values clarity, M (SD) | 27.7 (14.5) | 32.0 (18.4) |
22.7 (16.4)
|
40.3 (16.1)
| NS | 9.4** | A = C < D | |
Decisional support, M (SD) | 44.7 (14.2) | 45.9 (16.7) |
38.4 (18.2)
|
52.7 (11.9)
| NS | 3.4* | A = C < D | |
Effective DM, M (SD) | 32.8 (15.7) | 33.6 (18.7) |
27.3 (19.9)
|
39.2 (15.9)
| NS | 4.4* | D > C | |
Uncertainty, M (SD) | 36.6 (17.8) | 40.3 (16.8) |
40.9 (20.3)
|
39.8 (13.2)
| NS | 0.97 | NS | |
Informed DM, M (SD) | 65.2 (22.6) | 69.6 (22.9) |
64.1 (26.6)
|
74.5 (17.9)
| NS | 3.2* | A = C < D | |
Knowledge
| ||||||||
Knowledge post DA, M (SD) | 7.3 (1.9) | 7.2 (1.7) |
7.4 (1.7)
|
6.9 (1.8)
| NS | NS | ||
Time spent (minutes)
| ||||||||
Total time spent, M (SD) | 8.5 (7.4) | 9.3 (8.4) |
14.3 (9.2)
|
4.9 (4.4)
| NS | 9.2** | D < A < C | |
Time spent on information only, M (SD) | 8.5 (7.4) | 8.3 (7.3) |
11.8 (8.0)
|
4.9 (4.4)
| NS | 3.9* | D < A < C | |
Pages viewed Δ | 12.5 (2–38) | 14.4 (3–36) |
21 (9–36)
|
8.5 (3–17)
| NS | 27.61** | D < A < C | |
Made a decision, yes, n (%) | 56 (80) | 58 (82.8) | NS | NS |
Effect of type of DA on decision making, DA use, decisional conflict, knowledge (Primary analyses)
Effect of using the VCE on total DA use, decisional conflict (Secondary analyses)
Conclusion experiment 1
Experiment 2
Methods experiment 2
Study design
Participants
Procedure
Measurements
Statistics
Power calculation
Results experiment 2
Participants and socio-demographic characteristics
Effect of condition on decision making, DA use, decisional conflict, knowledge
Primary analyses
Information only VCE- (N = 65) | Information plus VCE (VCE+) (N = 132) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
A | No referral to VCE (n = 66) | With referral to VCE (n = 66) | Primary analysis (A vs B vs E) | Secondary analysis (H vs I) | ||||||||
Total (no referral) (N = 66) |
VCE not used (VCE + -) (n = 31)
|
VCE used (VCE++) (n = 35)
| Total (with referral) N = 66 |
VCE not used (VCE + -) (n = 17)
|
VCE used (VCE++) (n = 49)
| Total VCE not used (C + F)(n = 48) | Total VCE used (D + G)(n = 84) | F- value | F- value | Post hoc analysis | ||
B |
C
|
D
| E |
F
|
G
| H | I | |||||
Time spent (min) | 7.7 (5.6) | 8.9 (6.6) |
6.4 (6.5)
|
11.2 (6)
| 9.4 (6.9) |
4.8 (5.1)
|
11.1 (6.8)
| 5.8 (6.0) | 11.1 (6.4) | NS | 15.6** | H < I |
Time on informational pages | 7.7 (5.6) | 7.8 (5.93) |
6.4 (6.5)
|
8.9 (5.2)
| 7.1 (5.6) |
4.8 (5.1)
|
7.9 (5.6)
| 5.8 (6.0) | 8.3 (5.4) | NS | 4.3* | H < I |
Pages viewed (incl vce pages) | 13.3 (8.7) | 16.1 (9.7) |
11.1 (4.8)
|
20.4 (10.9)
| 17.4 (11.4) |
7.7 (3.6)
|
20.7 (11.5)
| 9.9 (4.6) | 20.5 (11.2) | NS | 20.9** | H < I |
Informational pages | 13.3(8.7) | 13.2 (6.1) |
11.1 (4.8)
|
15.1 (6.6)
| 11.9 (6.9) |
7.7 (3.6)
|
13.3 (7.3)
| 9.9 (4.6) | 14.1 (7.0) | NS | 7.1** | H < I |
Knowledge
| ||||||||||||
After viewing the DA | 7.5 (1.6) | 7.1 (1.9) |
7.3 (1.9)
|
6.9 (2.0)
| 7.2 (1.8) |
6.5 (2.4)
|
7.5 (1.5)
| 7.0 (2.1) | 7.2 (1.8) | NS | NS | |
Decisional conflict
| ||||||||||||
Total DCS M (SD) | 44.1 (12.3) | 43.6 (11.4) |
41.8 (10.1)
|
45.2 (12.3)
| 41.6 (9.5) |
44.5 (7.6)
|
40.6 (9.9)
| 42.8 (9.3) | 42.5 (11.2) | NS | NS | |
Values clarity M (SD) | 32.9 (14.7) | 34.2 (15.2) |
33.6 (13.3)
|
34.7 (16.8)
| 30.6 (13.7) |
37.7 (12.2)
|
28.1 (13.5)
| 35.1 (12.9) | 30.9 (15.2) | NS | NS | |
Decisional support M (SD) | 45.2 (14.4) | 45.3 (14.5) |
43.3 (12.4)
|
47.1 (16.0)
| 43.3 (12.4) |
48.5 (12.6)
|
41.5 (11.9)
| 45.1 (12.6) | 43.9 (13.5) | NS | NS | |
Effective DM M (SD) | 37.3 (16.7) | 34.2 (14.3) |
31.6 (12.9)
|
36.6 (15.2)
| 32.3 (13.3) |
32.7 (16.7)
|
32.1 (12.1)
| 32.0 (14.2) | 34.0 (13.6) | NS | NS | |
Uncertainty M (SD) | 41.5 (16.7) | 40.9 (16.7) |
41.1 (17.2)
|
40.7 (16.5)
| 39.6 (14.6) |
37.3 (13.8)
|
40.5 (14.9)
| 39.7 (16.1) | 40.6 (15.5) | NS | NS | |
Informed DM M (SD) | 66.0 (21.4) | 66.5 (18.2) |
62.9 (20.4)
|
69.7 (15.6)
| 65.4 (19.9) |
70.6 (15.9)
|
63.6 (21.0)
| 65.6 (19.1) | 66.2 (19.1) | NS | NS | |
Personality traits, high M (SD)
| ||||||||||||
Neuroticism | 3.1 (0.53) | 3.0 (0.61) |
2.9 (0.57)
|
3.1 (0.64)
| 3.1 (0.54) |
3.1 (0.62)
|
3.1 (0.52)
| 2.9 (0.58) | 3.1 (0.57) | NS | NS | |
Conscientiousness | 3.5 (0.54) | 3.6 (0.64) |
3.6 (0.59)
|
3.5 (0.69)
| 3.5 (0.63) |
3.4 (0.82)
|
3.5 (0.56)
| 3.5 (0.68) | 3.5 (0.61) | NS | NS | |
Monitoring | 19.7 (4.59) | 19.9 (4.31) |
20.1 (4.36)
|
19.7 (4.30)
| 19.7 (4.1) |
19.3 (4.36)
|
19.9 (4.08)
| 19.8 (4.34) | 19.8 (4.15) | NS | NS | |
Blunting | 18.6 (2.9) | 17.8 (3.11) |
18.1 (2.58)
|
17.5 (3.53)
| 18.1 (3.2) |
18.1 (3.49)
|
18.1 (3.17)
| 18.0 (2.88) | 17.9 (3.31) | NS | NS |