Moore G P, Lemyre B, Daboval T, Ding S, Dunn S, Akiki S, Barrowman N, Shephard A L, Lawson M L
Division of Neonatology, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada.
CHEO Research Institute, Ottawa, ON, Canada.
J Perinatol. 2017 Jun;37(6):728-734. doi: 10.1038/jp.2017.29. Epub 2017 Mar 30.
The objective of this study is to assess and modify an existing decision aid and field-test decision coaching with the modified aid during consultations with parents facing potential delivery at 23 to 24 weeks gestation.
International Patient Decision Aid Standards instrument (IPDASi) scoring deficits, multi-stakeholder group feedback and α-testing guided modifications. Feasibility/acceptability were assessed. The Decisional Conflict Scale was used to measure participants' decisional conflict before (T1) and immediately after (T2) the consultation.
IPDASi assessment of the existing aid (score 11/35) indicated it required updated data, more information and a palliative care description. Following modification, IPDASi score increased to 26/35. Twenty subjects (12 pregnancies) participated in field-testing; 15 completed all questionnaires. Most participants (89%) would definitely recommend this form of consultation. Decisional conflict scores decreased (P<0.001) between T1 (52±25) and T2 (10±16).
Field testing demonstrated that consultations using the aid with decision coaching were feasible, reduced decisional conflict and may facilitate shared decision-making.
本研究的目的是评估并修改现有的决策辅助工具，并在与妊娠23至24周面临潜在分娩的父母进行咨询时，对修改后的辅助工具进行现场测试决策指导。
国际患者决策辅助工具标准工具（IPDASi）评分缺陷、多利益相关者群体反馈和α测试指导修改。评估可行性/可接受性。使用决策冲突量表测量参与者在咨询前（T1）和咨询后立即（T2）的决策冲突。
对现有辅助工具的IPDASi评估（得分为11/35）表明，它需要更新数据、更多信息和姑息治疗描述。修改后，IPDASi得分提高到26/35。20名受试者（12例妊娠）参与了现场测试；15名完成了所有问卷。大多数参与者（89%）肯定会推荐这种咨询形式。决策冲突得分在T1（52±25）和T2（10±16）之间下降（P<0.001）。
现场测试表明，使用辅助工具并进行决策指导的咨询是可行的，减少了决策冲突，并可能促进共同决策。
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