Nozaki Kazuhiko, Okubo Chie, Yokoyama Yoko, Morita Akio, Akamatsu Rie, Nakayama Takeo, Fukuhara Shun-ichi, Hashimoto Nobuo
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Sokyo-ku, Kyoto, Japan.
Neurol Med Chir (Tokyo). 2007 Dec;47(12):531-6; discussion 536. doi: 10.2176/nmc.47.531.
Preventative treatments for unruptured cerebral aneurysms include craniotomy, endovascular treatment, and follow up. Since there is no agreement as to the best procedure, it is important to provide adequate information so that the patient and physician can share in the decision-making process. A multi-media DVD was created to inform patients of the facts. This study examined how effectively this DVD changes patients' recognition including knowledge of unruptured cerebral aneurysms. Forty-seven patients with unruptured cerebral aneurysms who sought neurosurgery consultation between December 2005 and February 2006 completed a questionnaire before and after watching the DVD, as well as at 3 months follow up. Before watching the DVD, the average knowledge score was 8.72 out of 15 total points. The average score increased to 12.4 after watching the DVD (p < 0.001). At 3 months follow up, the average score was 10.34, which was still higher than before watching the DVD (p < 0.01). Participants' knowledge about treatment methods also increased after watching the DVD (p < 0.001). Compared to 63.2% who were satisfied with their treatment decision before watching the DVD, 69.6% were satisfied with their decision after watching the DVD. All participants responded that the use of multi-media images was helpful in better understanding treatment options and in making informed decisions. The DVD was favorably accepted as a decision support tool by patients with unruptured cerebral aneurysm and effectively increased patients' knowledge.
未破裂脑动脉瘤的预防性治疗包括开颅手术、血管内治疗和随访。由于对于最佳治疗方法尚无共识,提供充分的信息以便患者和医生共同参与决策过程非常重要。制作了一张多媒体DVD来告知患者相关事实。本研究考察了这张DVD在改变患者认知方面的效果,包括对未破裂脑动脉瘤的了解。47例在2005年12月至2006年2月期间寻求神经外科会诊的未破裂脑动脉瘤患者在观看DVD之前、之后以及随访3个月时完成了一份问卷。观看DVD之前,平均知识得分在满分15分中为8.72分。观看DVD后平均得分提高到12.4分(p<0.001)。在随访3个月时,平均得分是10.34分,仍高于观看DVD之前(p<0.01)。观看DVD后参与者对治疗方法的了解也有所增加(p<0.001)。与观看DVD之前63.2%对治疗决策满意的患者相比,观看DVD之后69.6%的患者对其决策满意。所有参与者都表示多媒体图像有助于更好地理解治疗选择并做出明智的决策。这张DVD被未破裂脑动脉瘤患者作为决策支持工具欣然接受,并有效增加了患者的知识。