Decision aid for mammographic screening for women aged 40 to 49
DOI:
https://doi.org/10.5712/rbmfc18(45)3572Keywords:
Mammography, Health communication, Breast cancer, Mass screening, Use of scientific information for health decision making.Abstract
Introduction: Breast cancer screening in Brazil is recommended for women aged 50 to 69 years, according to national guidelines for early detection of breast cancer of the National Cancer Institute/Ministry of Health. Although it is traditionally disseminated only as a beneficial practice, scientific evidence points to its complexity and the need to communicate the balance between risks and benefits, especially in younger women. Objective: To describe the participatory process of developing a decision aid for breast cancer screening when sought by women aged between 40 and 49 years in Brazil. Methods: Qualitative-participatory study that involved nine physicians and 104 women in the development process, following the recommendations of the International Patient Decision Aid Standards, which include four stages: conversation circles, evidence synthesis, and decision aid review and evaluation by physicians and women. Results: The decision aid developed is unprecedented in Brazil and all the physicians who used it considered it useful to help the conversation about the risks and benefits of breast cancer screening; 88.9% assessed that the information facilitated understanding — a view shared by 80% of the women — and 77.8% considered that it reduced or did not interfere with the consultation time. The decision aid was later improved with the suggestions. Conclusions: The study showed that the decision aid achieved its objective to provide shared decision support and good acceptance between doctors and women.
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