开发并现场测试一款决策支持工具，以促进避孕咨询中的共享决策。
Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling.
机构信息
Department of Family & Community Medicine, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California, 1001 Potrero Avenue, San Francisco, CA, USA.
Department of Family & Community Medicine, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA.
出版信息
Patient Educ Couns. 2017 Jul;100(7):1374-1381. doi: 10.1016/j.pec.2017.02.009. Epub 2017 Feb 10.
OBJECTIVE
We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection.
METHODS
Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process.
RESULTS
Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool's content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement.
CONCLUSION
Our decision support tool appears acceptable to women in the family planning setting.
PRACTICE IMPLICATIONS
Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial.
目的
我们开发了一种基于平板电脑的决策支持工具，供女性在避孕咨询就诊前使用，以帮助她们就方法选择进行共同决策。
方法
我们借鉴了有关女性对避孕咨询偏好的形成性工作以及对医疗保健决策的概念理解，根据决策支持工具开发的最佳实践，迭代开发了故事板，然后是数字原型。我们使用定量和定性数据以及认知测试进行了试点测试。在整个开发过程中，我们从患者和提供者咨询小组获得了反馈。
结果
在试点测试中使用该工具的 96%的女性表示，该工具帮助她们选择了一种方法，定性访谈表明该工具的内容和呈现方式是可以接受的。与对照组相比，使用该工具的女性在对其方法完全满意的可能性方面表现出增加的趋势。参与者对认知测试的反应用于工具的改进。
结论
我们的决策支持工具在计划生育环境中似乎被女性接受。
实践意义
该工具的形成性评估支持其在做出避孕决策的患者中的实用性，这可以在随机对照试验中进一步评估。
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