Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education, City College of New York, New York, USA.
Patient Educ Couns. 2012 Oct;89(1):178-83. doi: 10.1016/j.pec.2012.04.012. Epub 2012 Jun 9.
Decision aids are designed to assist patients in understanding their health care choices but lower SES populations are less activated and may not be prepared to benefit. Activating interventions may help prepare patients for using decision aids.
We evaluated the impact of a decision aid video (DA) and the Patient Activation Intervention (PAI) on patient's level of activation measured by the Patient Activation Measure (PAM) and their decision-making confidence measured by the decision self-efficacy (DSE) scale. Patients were randomized into control, PAI alone, DA alone, and DA+PAI groups.
PAM and DSE scores increased significantly in all groups with repeated measures. Restricting analyses to those with pre-intervention PAM scores at stages 1 or 2, the change in PAM scores was significant only for the intervention groups. The change in DSE scores was significantly only in the DA group.
These findings provide support for the utility of the DA, the PAI, and the DA+PAI in activating lower SES individuals. The DA alone changed DSE scores in the least activated patients while the PAI and DA both changed PAM scores.
Interventions directed at increasing patient engagement in their care may be useful particularly for less activated patients from lower SES populations.
决策辅助工具旨在帮助患者了解其医疗保健选择，但社会经济地位较低的人群参与度较低，可能无法从中受益。激活干预措施可能有助于患者为使用决策辅助工具做好准备。
我们评估了决策辅助工具视频（DA）和患者激活干预（PAI）对患者的激活程度的影响，通过患者激活度量（PAM）进行衡量，以及他们的决策信心通过决策自我效能（DSE）量表进行衡量。患者被随机分为对照组、PAI 组、DA 组和 DA+PAI 组。
所有组的 PAM 和 DSE 评分均随着重复测量而显著增加。将分析限制在 PAM 评分处于第 1 或 2 阶段的具有干预前评分的患者中，仅干预组的 PAM 评分变化具有统计学意义。DSE 评分的变化仅在 DA 组中具有统计学意义。
这些发现为 DA、PAI 和 DA+PAI 在激活社会经济地位较低的个体方面的实用性提供了支持。单独的 DA 改变了最不活跃患者的 DSE 评分，而 PAI 和 DA 都改变了 PAM 评分。
旨在增加患者对其护理参与度的干预措施可能特别有用，尤其是针对来自社会经济地位较低人群的低活跃患者。
