• Wakako Osaka and Kazuhiro Nakayama.
• Department of Nursing Informatics, St. Luke's International University Graduate School of Nursing Science, Tokyo, Japan; School of Nursing, The Jikei University, Tokyo, Japan. Electronic address: osakawakako@gmail.com.
• Patient Educ Couns. 2017 Mar 1; 100 (3): 550-562.

ObjectiveWe aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer.MethodsTwo hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups.ResultsAt Time 3, decisional conflict was significantly reduced for Group 1 vs control (P=0.021, Cohen's d =0.26) and Group 2 vs control (P=0.008, Cohen's d=0.40).ConclusionThe DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer.Practice ImplicationsThe DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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