School of Health Sciences, University of Southampton, Southampton, UK.
J Clin Nurs. 2020 Jul;29(13-14):2251-2259. doi: 10.1111/jocn.15223. Epub 2020 Mar 3.
To develop and evaluate an evidence-based Continence Product Patient Decision Aid (CP-PDA) to reduce decisional conflict and support continence product choice for men postradical prostatectomy.
In 2018, 1.3 million men globally were diagnosed with prostate cancer. A common treatment is radical prostatectomy, usually leading to sudden onset of urinary incontinence. For people experiencing incontinence, products to contain leakage are fundamental to health-related quality of life, but many product users and healthcare professionals are unaware of available options. No evidence-based guidance on choosing products exists despite known physical and psychological burdens of poorly managed leakage (e.g. isolation, anxiety, depression, skin damage).
4 phases, underpinned by international decision aid guidance. Evidence/expert opinion: Literature review; consultation with specialist continence clinicians (n = 7) to establish evidence base. Prototype: CP-PDA developed with continence specialist (n = 7) feedback. Alpha testing (stakeholders): CP-PDA materials were provided to expert patients (n = 10) and clinicians (n = 11) to assess content/presentation. Beta testing (field) following CONSORT guidelines, registered NIHR CPMS 31077: Men (n = 50) postradical prostatectomy randomised to evaluate usability and decision-making using the Decisional Conflict Scale compared with usual care.
An algorithm differentiating patients by mobility, dependency, cognitive impairment and type/level of leakage, leading to 12 user groups, was developed. For each group, an option table and associated product information sheets guide product choice. Total Decisional Conflict Score for men using the CP-PDA was significantly better than for men without. CP-PDA users reported greater confidence in product knowledge and choice.
This is the first evidence-based CP-PDA, developed using an internationally recognised method. Compared to usual care, it significantly reduced decisional conflict for men choosing continence products postprostatectomy.
The CP-PDA provides nurses with the first comprehensive, evidence-based intervention to help postprostatectomy men in complex continence product choices. An online version is available: www.continenceproductadvisor.org.
开发和评估基于证据的控尿产品患者决策辅助工具（CP-PDA），以减少男性根治性前列腺切除术后的决策冲突并支持控尿产品选择。
2018 年，全球有 130 万人被诊断出患有前列腺癌。一种常见的治疗方法是根治性前列腺切除术，通常会导致尿失禁突然发作。对于经历尿失禁的人来说，包含漏液的产品对健康相关生活质量至关重要，但许多产品使用者和医疗保健专业人员不知道可用的选择。尽管管理不善的漏液会带来身体和心理负担（例如隔离、焦虑、抑郁、皮肤损伤），但没有关于选择产品的基于证据的指导。
分 4 个阶段进行，以国际决策辅助指南为基础。证据/专家意见：文献回顾；咨询 7 名专业控尿临床医生以确定证据基础。原型：在控尿专家（n=7）的反馈下开发 CP-PDA。阿尔法测试（利益相关者）：向专家患者（n=10）和临床医生（n=11）提供 CP-PDA 材料，以评估内容/演示。贝塔测试（现场）遵循 CONSORT 指南，注册 NIHR CPMS 31077：50 名男性根治性前列腺切除术后随机分组，使用决策冲突量表评估可用性和决策，与常规护理相比。
开发了一种根据移动性、依赖性、认知障碍和漏液类型/水平对患者进行区分的算法，导致出现 12 个用户组。对于每个组，选项表和相关产品信息表都指导产品选择。使用 CP-PDA 的男性的总决策冲突评分明显优于没有使用 CP-PDA 的男性。CP-PDA 用户对产品知识和选择的信心更大。
这是第一个使用国际认可方法开发的基于证据的 CP-PDA。与常规护理相比，它显著降低了男性在前列腺切除术后选择控尿产品的决策冲突。
CP-PDA 为护士提供了第一个全面的、基于证据的干预措施，帮助前列腺切除术后的男性做出复杂的控尿产品选择。一个在线版本可在：www.continenceproductadvisor.org 获得。
