Department of Gynecology and Obstetrics, Amsterdam UMC University Medical Center, Amsterdam, the Netherlands.
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.
Patient Educ Couns. 2021 Sep;104(9):2259-2265. doi: 10.1016/j.pec.2021.02.027. Epub 2021 Feb 15.
Is the level of shared decision-making (SDM) higher after introduction of a SDM package (including encounter decision aids on treatment options for heavy menstrual bleeding and training for clinicians) than before?.
This before-after study, performed in OB-GYN practice, compared consultations before and after introduction of a SDM package. The target sample size was 25 patients per group. Women seeking treatment for heavy menstrual bleeding were eligible. After their appointments, patients filled out a three-item patient-reported SDM measure. Treatment discussions were audio-recorded and rated for SDM using Observer OPTION. Consultation transcripts in the 'after' group were checked for adherence to the steps required for intended use of decision aids.
16 gynaecologists participated. 25 patients participated before introduction of the decision aids and 28 after. The proportion of women reporting optimal SDM was higher after introduction (75 %) than before (50 %;p < 0.001). The mean observer-rated level of SDM was also significantly higher after than before (MD = 12.50,95 % CI 5.53-19.47).
The level of SDM was higher after the introduction of the package than before.
This study was conducted in a real-life setting in three clinics, both large academic and small rural, offering opportunities for implementation in different type of organizations.
在引入共享决策（SDM）方案（包括关于治疗月经过多的治疗选择的医患会谈决策辅助工具和对临床医生的培训）后，SDM 的水平是否会更高？
这项在妇产科实践中进行的前后对照研究比较了 SDM 方案引入前后的咨询情况。目标样本量为每组 25 名患者。因月经过多寻求治疗的女性符合条件。在预约结束后，患者填写了一份包含三项内容的患者报告 SDM 测量表。使用 Observer OPTION 对治疗讨论进行录音并对 SDM 进行评分。“后”组的咨询记录检查了是否遵守决策辅助工具预期使用所需的步骤。
16 名妇科医生参与了该研究。25 名患者在引入决策辅助工具之前参加了研究，28 名患者在引入之后参加了研究。报告最佳 SDM 的女性比例在引入后（75%）高于引入前（50%；p<0.001）。观察者评估的 SDM 水平也明显高于引入前（MD=12.50，95%CI 5.53-19.47）。
在引入方案后，SDM 的水平高于引入前。
这项研究在三个诊所的真实环境中进行，包括大型学术诊所和小型农村诊所，为在不同类型的组织中实施提供了机会。
