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评价一种关于男性结扎的患者决策辅助工具对决策过程的影响:一项随机试验。

Evaluation of the effect of a patient decision aid about vasectomy on the decision-making process: a randomized trial.

机构信息

Department of Family and Emergency Medicine, Université Laval, and Centre de recherche du Centre hospitalier universitaire de Québec, Hôpital St-François d'Assise, Québec, Canada.

出版信息

Contraception. 2010 Dec;82(6):556-62. doi: 10.1016/j.contraception.2010.05.003. Epub 2010 Jun 17.

Abstract

BACKGROUND

Between 7% and 10% of men who choose vasectomy as a contraceptive method regret their decision. This study evaluates the effect of a patient decision aid (PtDA) designed to help men decide whether or not to have a vasectomy.

STUDY DESIGN

Men considering vasectomy were randomized to an experimental group that received a full PtDA containing information and values guidance (n=32) or to a control group that received an abridged PtDA containing information only (n=31).

RESULTS

Mean Decisional Conflict Scale (DCS) scores before and after the intervention were 2.6±0.4 and 1.9±0.4 in the experimental group and 2.5±0.4 and 1.8±0.4 in the control group (p=.94), respectively. Mean knowledge of vasectomy scores before and after the intervention were 50%±16% and 72%±18% in the experimental group and 55%±18% and 71%±15% in the control group (p=.40), respectively. At baseline, all participants were undecided as to whether to have a vasectomy. After the intervention, 60% of experimental group participants and 53% of control group participants had made a definite decision (p=.58).

CONCLUSION

In men considering vasectomy, both versions of the PtDAs improved the quality of decision-making process to a similar extent. Information alone may be sufficient to support good decision making in these patients.

摘要

背景

选择输精管结扎作为避孕方法的男性中,有 7%至 10%会后悔他们的决定。本研究评估了一种旨在帮助男性决定是否进行输精管结扎术的患者决策辅助工具(PtDA)的效果。

研究设计

考虑进行输精管结扎术的男性被随机分为实验组,他们接受了包含信息和价值观指导的完整 PtDA(n=32)或对照组,他们接受了仅包含信息的简化 PtDA(n=31)。

结果

实验组干预前后的平均决策冲突量表(DCS)评分分别为 2.6±0.4 和 1.9±0.4,对照组分别为 2.5±0.4 和 1.8±0.4(p=.94)。实验组干预前后的输精管结扎知识平均评分分别为 50%±16%和 72%±18%,对照组分别为 55%±18%和 71%±15%(p=.40)。在基线时,所有参与者都不确定是否要进行输精管结扎术。干预后,实验组有 60%的参与者和对照组有 53%的参与者做出了明确的决定(p=.58)。

结论

在考虑进行输精管结扎术的男性中,两种版本的 PtDA 都在相似程度上改善了决策过程的质量。仅提供信息可能足以支持这些患者做出良好的决策。

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