Reproductive decision-making in the context of hereditary cancer: the effects of an online decision aid on informed decision-making

Author:

Reumkens Kelly,Tummers Marly H. E.,Severijns YilORCID,Gietel-Habets Joyce J. G.,van Kuijk Sander M. J.,Aalfs Cora M.,van Asperen Christi J.,Ausems Margreet G. E. M.,Collée Margriet,Dommering Charlotte J.,Kets Marleen,van der Kolk Lizet E.,Oosterwijk Jan C.,Tjan-Heijnen Vivianne C. G.,van der Weijden Trudy,de Die-Smulders Christine E. M.,van Osch Liesbeth A. D. M.

Abstract

AbstractIndividuals having a genetic predisposition to cancer and their partners face challenging decisions regarding their wish to have children. This study aimed to determine the effects of an online decision aid to support couples in making an informed decision regarding their reproductive options. A nationwide pretest-posttest study was conducted in the Netherlands among 131 participants between November 2016 and May 2018. Couples were eligible for participation if one partner had a pathogenic variant predisposing for an autosomal dominant hereditary cancer syndrome. Participants completed a questionnaire before use (T0), and at 3 months (T3) after use of the decision aid to assess the primary outcome measure informed decision-making, and the secondary outcome measures decisional conflict, knowledge, realistic expectations, level of deliberation, and decision self-efficacy. T0–T3 comparisons show an overall positive effect for all outcome measures (all ps < 0.05; knowledge (ES = − 1.05), decisional conflict (ES = 0.99), participants’ decision self-efficacy (ES = −0.55), level of deliberation (ES = − 0.50), and realistic expectations (ES = − 0.44). Informed decision-making increased over time and 58.0% of the participants made an informed reproductive decision at T3. The online decision aid seems to be an appropriate tool to complement standard reproductive counseling to support our target group in making an informed reproductive decision. Use of the decision aid may lessen the negative psychological impact of decision-making on couples’ daily life and wellbeing.

Funder

Alpe d'HuZes

Publisher

Springer Science and Business Media LLC

Subject

Genetics(clinical),Public Health, Environmental and Occupational Health,Epidemiology

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