15250-m-cuypers

73 Decision aid development and usability testing 4 Table 2. DA Values clarification Exercises (VCEs) Step 2: Curative treatment versus active surveillance Topic Reasons for active surveillance Reasons for treatment Acceptance of deferring treatment I am confident enough that I will be treated on time I do not want to postpone treatment because I do not want to be too late Avoiding possible unnecessary treatment If treatment might be unnecessary,I would rather wait I prefer treatment,even if it might be unnecessary Acceptance of treatment side-effects I find possible treatment side effectslike erectile and urinary dysfunctions difficult to accept’ I find the possible treatment side effects acceptable’ Step 3: Surgery versus radiotherapy Topic Reasons for surgery Reasons for radiotherapy Treatment procedure I find it important that all cancer cells are removed from my body I find it important that the cancer cells die andnot grow further Treatment side-effects I find bowel problems worse than incontinence I find incontinenceworse than bowel problems Secondary treatment I am comforted by the thought that I can have radiation if surgery is unsuccessful I accept that surgery is difficultafter radiation Fear for surgery I am not anxious about surgery I am anxious about surgery Usability testing Usability testing resulted in 212 usability and content comments. Care providers mainly reported feedback on the specific radiotherapy related content, a need for more descriptive notes to accompany the illustrations and risk representations. Patients mainly reported usability remarks and comments about the DA summary section. All participants reported that the writing style was comprehensible and that the DA structure and navigation were clear. A summary of the results from the think-aloud procedure and interview results are presented in Table 3. In addition to the usability items, all care providers (100%) indicated they would offer the DA to patients and all patients (100%) indicated they would recommend the DA to other patients. After discussion of the results in the development team, three main adjustments to the final DA were made: (1) accompanying legends were added, (2) radiotherapy content was adjusted, and (3) the DA summary section was simplified. The final version of the DA complied to all IPDAS criteria 6 (Table 4).