Decision-support for couples with hereditary cancer and child wish: weighing pros and cons of reproductive options regarding transmission of gene mutations.

Levels of decisional conflict will be assessed by means of the Decisional Conflict Scale (DCS; O¡¯Connor, 1995). The DCS contains 16 items divided into three subscales, measuring uncertainty about selection of alternatives, specific factors contributing to uncertainty, and perceived effectiveness of decision making.

Secondary outcomes include knowledge of different reproductive options, accuracy of perceived risks, satisfaction with the decision and the decision making process (e.g., Satisfaction with Decision Scale; Holmes-Rovner et al., 1996), and decision self-efficacy (Decision Self-efficacy Scale; Bunn & O¡¯Connor, 1996). The Multidimensional Measure of Informed Choice (MMIC; Marteau et al., 2001) will be used to assess informed choice. It should be noted that using the MMIC, an informed choice is based on relevant knowledge, is consistent with a person¡¯s values and is behaviourally implemented. As behavioural implementation or adherence to the decision (i.e. uptake of the test or treatment) is unlikely to have occurred for many couples during the study period, only subscales will be used for full analysis. Furthermore, acceptability of the brochures and DA will be assessed by recording whether women used the resource, the time taken to use the resource and how helpful they thought the resource was. For the DA, objective recordings of DA use will be available.