PEGASUS was created to help people considering appearance-altering surgery. It’s designed for healthcare professionals to assist patients in making decisions that align with their personal values and goals.
After patients receive information about their options, a specially trained ‘decision coach’ (like a specialist nurse or psychologist) guides them through the PEGASUS process. This helps patients discuss their expectations, allowing the surgeon to determine if they are realistic and address any unrealistic ones, if needed.
PEGASUS has been used with patients considering breast reconstruction or augmentation but is suitable for anyone thinking about surgery that could change their appearance.
For more information and to access the PEGASUS training pack, visit pegasusdecisionmaking.com.
We’d to have your feedback on PEGASUS – please complete our quick survey here.
“It’s the dialogue that you have that enables them (patients) to move from a really vague idea of something they might want to achieve into operationalising three or four targeted specific goals with clear, you know, measurable ways in which they will now if it’s been successful.”
Health professional
“Things go round and round and round and in lots of different ways depending on how you are feeling. Getting it down on paper is a completely different matter… it forced me to really think about what I was doing”
Patient
Podcast
You can hear more about this resource on this episode of the Appearance Matters podcast.
The Research
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PEGASUS was developed by a team at CAR after research showed a need for support with decision making about surgery that would alter patients’ appearance. A study at the Royal Free Hospital in 2011 found that PEGASUS was well received by patients and their surgical team.
In 2015, Breast Cancer Now funded a trial to test the PEGASUS intervention for women considering breast reconstruction. Conducted at five NHS sites, the trial involved over 140 women, with 56 receiving PEGASUS. The results showed that PEGASUS helped women focus on their priorities and formulate questions for their healthcare providers. Healthcare professionals also found it useful for understanding each woman’s needs. This study highlighted PEGASUS as a valuable decision-making tool, despite some research challenges.
Publications
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Clarke, A., Paraskeva, N., White, P., Tollow, P., Hansen, E., & Harcourt, D. (2020). PEGASUS: the Design of an Intervention to Facilitate Shared Decision-making in Breast Reconstruction. Journal of Cancer Education, https://doi.org/10.1007/s13187-019-01656-6.Available from https://uwe-repository.worktribe.com/output/4405892
Guest, E., Paraskeva, N., Griffiths, C., Hansen, E., Clarke, A., Baker, E., & Harcourt, D. (2021). The nature and importance of women’s goals for immediate and delayed breast reconstruction. Journal of Plastic, Reconstructive and Aesthetic Surgery, 74(9), 2169-2175. https://doi.org/10.1016/j.bjps.2020.12.085.
Harcourt, D., Griffiths, C., Baker, E., Hansen, E., White, P., and Clarke, E. (2016). The acceptability of PEGASUS: an intervention to facilitate decision-making with women contemplating breast reconstruction. Psychology, Health & Medicine, 21(2), 248-253.
Harcourt, D., Paraskeva, N., White, P., Powell, J., and Clarke, A. (2017). A study protocol of the effectiveness of PEGASUS: a multi-centred study comparing an intervention to promote shared decision making about breast reconstruction with treatment as usual. BMC Medical Informatics and Decision Making, 17, 143.
Paraskeva, N., Guest, E., Lewis-Smith, H. and Harcourt, D. (2018) Assessing the effectiveness of interventions to support patient decision making about breast reconstruction: A systematic review. The Breast, 40, 97-105.
Paraskeva, N., Tollow, P., Clarke, A., White, P., Powell, J., Cox, D., & Harcourt, D. (2021). A multi-centred sequential trial comparing PEGASUS, an intervention to promote shared decision making about breast reconstruction, with usual care. Journal of Plastic, Reconstruction and Aesthetic Surgery. https://doi.org/10.1016/j.bjps.2021.11.033
Tollow, P., Paraskeva, N., Clarke, A., White, P., Powell, J., Cox, D., & Harcourt, D. (2021). “They were aware of who I was as a person”: Patients’ and health professionals’ experiences of using the PEGASUS intervention to facilitate decision-making around breast reconstruction. European Journal of Cancer Care, 30(5), http://doi.org/10.1111/ecc.13464.
Tollow, P., Paraskeva, N., Clarke, A., White, P., Powell, J., Cox, D., & Harcourt, D. (2020).Challenges and reflections from a multi-centre trial of a psychosocial oncology intervention. European Journal of Cancer Care, 30(2). https://doi.org/10.1111/ecc.13384
Acknowledgements
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Research into the acceptability, feasibility, and effectiveness of PEGASUS has been conducted in collaboration with Dr. Elizabeth Baker at the Royal Free Hospital; Dr. Catrin Griffiths at the Centre for Appearance Research (CAR); Dr. Esther Hansen at the Royal Free Hospital; Dr. Nicole Paraskeva at CAR; Professor Jane Powell at the University of the West of England (UWE); Dr. Pippa Tollow at CAR; Dr. Paul White at UWE; and Ms. Danielle Cox at CAR.
We sincerely thank the staff at the following NHS trusts for their collaboration in researching the acceptability, feasibility, and effectiveness of PEGASUS for women considering breast reconstruction: Cardiff and Vale University Health Board, Hampshire Hospitals NHS Foundation Trust, North Bristol NHS Trust, Royal Cornwall Hospital NHS Trust, Royal Free London NHS Foundation Trust, and Royal United Hospitals NHS Trust.
Funders
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Research investigating the effectiveness of PEGASUS for women making decisions around breast reconstruction has been supported by Breast Cancer Now (grant no. 2014NovPR415). A feasibility study was funded by Breast Cancer Campaign (ref 2011MaySP25).
Research exploring the acceptability of the PEGASUS intervention with breast augmentation patients was funded by the National Institute of Aesthetic Research.