Rexwinkel Robyn, Rippen Hester, Blokzijl-Boezeman Inge J M, de Klein Zonja, Walhof Christel M, van der Kraan Josine, Benninga Marc A, Tabbers Merit M
Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Room C2-312, PO Box 22700, 1100, DD, Amsterdam, The Netherlands.
Dutch Child and Hospital Foundation, Utrecht, The Netherlands.
Eur J Pediatr. 2021 Apr;180(4):1235-1242. doi: 10.1007/s00431-020-03868-1. Epub 2020 Nov 9.
The "3 Good Questions" program was developed to increase shared decision making. The current pilot-study determined the feasibility of these questions to increase shared decision-making in Dutch pediatric medicine. Pre-/postintervention surveys were used to include children (10-18 years) at pediatric outpatient clinics of four hospitals in the Netherlands. After their appointment, two different groups of children completed the questionnaires. Group 1 filled in the survey before the intervention; group 2 completed the survey after active implementation of the "3 Good Questions" program. The primary outcome was to determine the feasibility (reach, applicability). Secondary outcomes were related to patient involvement in healthcare and treatment decisions and decision-making process between child and healthcare professional. In total, 168 and 114 children in groups 1 and 2 (61 vs 63% female, P = 0.68; age 13.3 ± 2.4 vs 13.8 ± 2.4 years, P = 0.72), respectively, completed the questionnaire. In group 2, 44% of children were aware of the "3 Good Questions", of whom 18% posed ≥ 1 of the "3 Good Questions" during their appointment (feasibility). The "3 Good Questions" program led to more shared decision-making (SDM-Q-9: P = < 0.001;95%CI: - 2.43 to - 1.17). The majority of children who have read or heard of the "3 Good Questions" would recommend this program to other children.Conclusion: Implementation of the "3 Good Questions" program seemed feasible, although it is necessary to further explore the implementation of this program at national level as a simple way for children and healthcare professionals to share decisions in practice. What is known • Children have the right to be included in decision-making, and inclusion can improve patient satisfaction and quality of care, and reduce costs. • The "3 Good Questions" program was successfully implemented in adult healthcare to increase shared decision making, and therefore these "3 Good Questions" have been adapted to a child version. What is new • In this pilot study, we found that the implementation of the "3 Good Questions" program to increase shared decision-making in pediatric medicine seemed feasible. Although it is necessary to further explore the implementation of the "3 Good Questions" program at national level as a simple way for children and healthcare professionals to share decisions in practice.
“三个好问题”项目旨在促进共同决策。当前的试点研究确定了这些问题在荷兰儿科学领域促进共同决策的可行性。干预前后的调查被用于纳入荷兰四家医院儿科门诊的儿童（10 - 18岁）。预约就诊后，两组不同的儿童完成问卷。第一组在干预前填写问卷；第二组在积极实施“三个好问题”项目后完成问卷。主要结果是确定可行性（覆盖面、适用性）。次要结果与患者参与医疗保健和治疗决策以及儿童与医疗保健专业人员之间的决策过程有关。第一组和第二组分别有168名和114名儿童完成问卷（女性比例分别为61%和63%，P = 0.68；年龄分别为13.3 ± 2.4岁和13.8 ± 2.4岁，P = 0.72）。在第二组中，44%的儿童知晓“三个好问题”，其中18%的儿童在就诊期间提出了≥1个“三个好问题”（可行性）。“三个好问题”项目促进了更多的共同决策（SDM - Q - 9：P = < 0.001；95%CI： - 2.43至 - 1.17）。大多数读过或听说过“三个好问题”的儿童会向其他儿童推荐该项目。结论：“三个好问题”项目的实施似乎可行，不过有必要在国家层面进一步探索该项目的实施，作为儿童和医疗保健专业人员在实践中共同决策的一种简单方式。已知信息：• 儿童有权参与决策，且参与能提高患者满意度和医疗质量，并降低成本。• “三个好问题”项目在成人医疗保健领域成功实施以促进共同决策，因此这些“三个好问题”已改编为儿童版。新发现：• 在本试点研究中，我们发现实施“三个好问题”项目以促进儿科学领域的共同决策似乎可行。尽管有必要在国家层面进一步探索该项目的实施，作为儿童和医疗保健专业人员在实践中共同决策的一种简单方式。
