Emmett Clare L, Murphy Deirdre J, Patel Roshni R, Fahey Tom, Jones Claire, Ricketts Ian W, Gregor Peter, Macleod Maureen, Montgomery Alan A
Academic Unit of Primary Health Care, University of Bristol, Bristol, UK.
Health Expect. 2007 Jun;10(2):161-72. doi: 10.1111/j.1369-7625.2006.00429.x.
To develop and pilot two computer-based decision aids to assist women with decision-making about mode of delivery after a previous caesarean section (CS), which could then be evaluated in a randomized-controlled trial.
Women with a previous CS are faced with a decision between repeat elective CS and vaginal birth after caesarean. Research has shown that women may benefit from access to comprehensive information about the risks and benefits of the delivery options.
A qualitative pilot study of two novel decision aids, an information program and a decision analysis program, which were developed by a multidisciplinary research team.
15 women who had recently given birth and had previously had a CS and 11 pregnant women with a previous CS, recruited from two UK hospitals. Women were interviewed and observed using the decision aids.
Participants found both decision aids useful and informative. Most liked the computer-based format. Participants found the utility assessment of the decision analysis program acceptable although some had difficulty completing the tasks required. Following the pilot study improvements were made to expand the program content, the decision analysis program was accompanied by a training session and a website version of the information program was developed to allow repeat access.
This pilot study was an essential step in the design of the decision aids and in establishing their acceptability and feasibility. In general, participating women viewed the decision aids as a welcome addition to routine antenatal care. A randomized trial has been conducted to establish the effectiveness and cost-effectiveness of the decision aids.
开发并试行两款基于计算机的决策辅助工具，以帮助曾行剖宫产术（CS）的女性在分娩方式上做出决策，随后可在随机对照试验中对其进行评估。
曾行剖宫产术的女性面临再次选择性剖宫产和剖宫产术后阴道分娩之间的抉择。研究表明，女性若能获取有关分娩方式风险和益处的全面信息，可能会从中受益。
对两款新型决策辅助工具进行定性试点研究，这两款工具分别是一个信息程序和一个决策分析程序，由多学科研究团队开发。
从英国两家医院招募了15名近期分娩且曾行剖宫产术的女性以及11名曾行剖宫产术的孕妇。使用决策辅助工具对这些女性进行访谈和观察。
参与者认为这两款决策辅助工具都很有用且信息丰富。大多数人喜欢基于计算机的形式。参与者认为决策分析程序的效用评估是可以接受的，尽管有些人在完成所需任务时遇到困难。试点研究之后进行了改进，以扩展程序内容，为决策分析程序配备了培训课程，并开发了信息程序的网站版本以便重复访问。
这项试点研究是决策辅助工具设计以及确定其可接受性和可行性的关键一步。总体而言，参与研究的女性认为决策辅助工具是常规产前护理中一项受欢迎的补充。已开展一项随机试验以确定决策辅助工具的有效性和成本效益。
