乳腺癌患者在乳房切除术后面临立即乳房重建 (BR) 的复杂决定。我们评估了在线决策辅助在改善考虑立即 BR 的乳腺癌患者的决策过程、决策质量和健康结果方面的功效。在一项多中心随机对照试验中，患者被分配到接受护理的干预组：通常（CAU）可访问在线决策辅助，或对照组接受 CAU 并提供信息传单。主要结果是决策冲突。次要结果评估决策过程（例如决策准备、对信息的满意度）、决策质量（决策后悔、知识）和健康结果（例如对 BR 结果的满意度、身体形象）。患者在基线 (T0)、整形外科医生咨询后 1 周 (T1)、术后 3 个月 (T2) 和术后 12 个月 (T3) 填写问卷。我们纳入了 250 名患者。两组的决策冲突随着时间的推移而减少，组间没有差异。干预参与者感觉比对照组做好了更好的决策准备（P = .002）。在 T2 时，87% 的干预参与者对有关 BR 的信息（非常）满意，而对照组参与者的这一比例为 73% (P = .011)。在任何其他结果中均未观察到组间显着差异。我们的在线决策辅助在减少决策冲突方面与关于乳房切除术后立即 BR 的信息传单一样有效。然而，决策援助通过让乳腺癌患者更好地为有关立即 BR 的决策做好准备，显着改善了决策过程。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 代表美国整形外科医生协会出版。版权所有。

Breast cancer patients face complex decisions about immediate breast reconstruction (BR) after mastectomy. We evaluated the efficacy of an online decision aid in improving the decision-making process, decision quality and health outcomes in breast cancer patients considering immediate BR.In a multicenter randomized controlled trial, patients were allocated to either the intervention group receiving care-as-usual (CAU) with access to an online decision aid, or the control group receiving CAU with an information leaflet. The primary outcome was decisional conflict. Secondary outcomes assessed the process of decision making (e.g. preparation for decision making, satisfaction with information), decision quality (decision regret, knowledge) and health outcomes (e.g. satisfaction with BR outcomes, body image). Patients completed questionnaires at baseline (T0), 1 week after consultation with a plastic surgeon (T1), 3 months (T2), and 12 months post-surgery (T3).We included 250 patients. Decisional conflict decreased over time in both groups, with no between group differences. Intervention participants felt better prepared for decision making than controls (P = .002). At T2, 87% of intervention participants were (very) satisfied with the information about BR, compared to 73% of control participants (P = .011). No significant between group differences were observed in any other outcome.Our online decision aid was as effective in reducing decisional conflict as an information leaflet about immediate BR after mastectomy. However, the decision aid substantially improved the decision-making process by better preparing breast cancer patients for decisions about immediate BR.Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.