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为出现更年期症状的女性做好准备,以共同决策治疗方案。

Preparing women experiencing symptoms of menopause for shared decision making about treatment.

机构信息

Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA.

Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.

出版信息

Menopause. 2021 Jul 12;28(9):1060-1066. doi: 10.1097/GME.0000000000001807.

Abstract

OBJECTIVE

To develop a decision support intervention that can be used with women experiencing menopausal symptoms to facilitate treatment shared decision making.

METHODS

Our research team contacted patients with reported menopausal symptoms by telephone to obtain consent and administer a baseline survey. Subsequently, we sent participants a booklet on the treatment of menopausal symptoms. A nurse educator then contacted participants by telephone to review the booklet and guide them through a structured decision counseling exercise designed to help clarify treatment preference. A 60-day endpoint telephone survey was completed.

RESULTS

Forty-eight consenting participants completed the baseline survey and 37 (77%) also completed a decision counseling session. At baseline, 19 of the women who had decision counseling were not being treated for menopausal symptoms and 18 were being treated. After decision counseling, 13 (68%) participants who were not being treated and 14 (78%) who were being treated identified a preferred treatment. Comparison of baseline and endpoint survey data showed that participant treatment knowledge increased (P = 0.007) and treatment decisional conflict decreased (P < 0.001). Furthermore, 71% of participants reported that they had received new information about treatment and 94% said they believed better prepared to discuss treatment with their healthcare provider.

CONCLUSIONS

Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.

摘要

目的

开发一种决策支持干预措施,可用于有更年期症状的女性,以促进治疗的共同决策。

方法

我们的研究团队通过电话联系有报告的更年期症状的患者以获得同意并进行基线调查。随后,我们向参与者发送了一本关于更年期症状治疗的小册子。然后,一名护士教育者通过电话联系参与者,回顾小册子并指导他们进行结构化的决策咨询练习,旨在帮助澄清治疗偏好。完成了 60 天的终点电话调查。

结果

48 名同意参加的参与者完成了基线调查,其中 37 名(77%)还完成了决策咨询课程。在基线时,有决策咨询的 19 名妇女没有接受更年期症状的治疗,而 18 名正在接受治疗。在决策咨询后,13 名(68%)未接受治疗的参与者和 14 名(78%)正在接受治疗的参与者确定了首选的治疗方法。与基线和终点调查数据的比较表明,参与者的治疗知识增加(P=0.007),治疗决策冲突减少(P<0.001)。此外,71%的参与者报告说他们收到了有关治疗的新信息,94%的参与者表示他们认为自己已经做好了更好的准备与医疗保健提供者讨论治疗方案。

结论

护士主导的决策咨询增加了参与者的治疗知识,减少了治疗决策冲突,并有助于澄清治疗偏好。实施这一策略可以帮助促进医生与患者共同决策治疗更年期症状。

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