Mainz Hanne, Frandsen Lone, Lind Martin, Fauno Peter, Lomborg Kirsten
Clinic of Sports Traumatology, Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark.
Center for Research in Patient Involvement, Aarhus University Hospital, Denmark.
MDM Policy Pract. 2022 Mar 4;7(1):23814683221081434. doi: 10.1177/23814683221081434. eCollection 2022 Jan-Jun.
Patients with anterior crucial ligament injury are faced with a choice between surgery or nonsurgical treatment with intensive rehabilitation. Patients must be involved in the decision making to choose a treatment that meets their individual values, lifestyle, and conditions. The aim of the study was to describe, develop, and evaluate a patient decision aid to support shared decision making. The development of a patient decision aid was based on international criteria, current literature, and former patients' experiences and suggestions on how to optimize the decision-making process. The patient decision aid was evaluated by the SDM-Q9 questionnaire and semistructured interviews with patients and doctors. On a scale from 0 to 5, patients experienced a high degree of shared decision making in their treatment decision both before (score 4.3) and after (score 4.3) implementation of the patient decision aid ( = .72). From interviews, patients expressed that they found the patient decision aid very useful. Reflection time was especially important for some patients. Doctors reported that the patient decision aid improved shared decision making by supporting the dialogue clarifying patients' values concerning issues important for treatment choices. A systematic process involving patients with an anterior crucial ligament injury was successfully used to develop a patient decision aid for treatment options. No statistically significant difference in the SDM-Q9 score was found presumably caused by the ceiling effect. However, patients experienced the decision aid as very useful when making treatment decisions, and doctors reported that it improved the dialogue clarifying patients' values important for the treatment options. The developing process and patient decision aid can be used as inspiration in similar situations to increase shared decision making in treatment choices.
A patient decision aid for anterior cruciate ligament injured patients was developed based on international criteria, the current literature, and patients' experiences and suggestions on how to optimize the decision-making process about surgical and nonsurgical treatment.The decision aid improved shared decision making by supporting the dialog between the patient and the doctor to clarify the patients' values concerning issues important for the treatment options.
前交叉韧带损伤患者面临手术治疗或非手术强化康复治疗的选择。患者必须参与决策，以选择符合其个人价值观、生活方式和病情的治疗方法。本研究的目的是描述、开发和评估一种患者决策辅助工具，以支持共同决策。患者决策辅助工具的开发基于国际标准、当前文献以及既往患者关于如何优化决策过程的经验和建议。通过SDM-Q9问卷以及对患者和医生的半结构化访谈对患者决策辅助工具进行评估。在0至5分的量表上，患者在实施患者决策辅助工具之前（得分4.3）和之后（得分4.3）的治疗决策中均体验到高度的共同决策（P = 0.72）。从访谈中可知，患者表示他们发现患者决策辅助工具非常有用。反思时间对一些患者尤为重要。医生报告称，患者决策辅助工具通过支持对话，阐明患者在对治疗选择至关重要的问题上的价值观，从而改善了共同决策。一个涉及前交叉韧带损伤患者的系统过程被成功用于开发针对治疗选择的患者决策辅助工具。SDM-Q9评分未发现统计学上的显著差异，可能是由天花板效应导致的。然而，患者在做出治疗决策时认为决策辅助工具非常有用，医生报告称它改善了关于阐明患者对治疗选择至关重要的价值观的对话。开发过程和患者决策辅助工具可在类似情况下作为借鉴，以增加治疗选择中的共同决策。
基于国际标准、当前文献以及患者关于如何优化手术和非手术治疗决策过程的经验和建议，开发了一种针对前交叉韧带损伤患者的患者决策辅助工具。该决策辅助工具通过支持患者与医生之间的对话，阐明患者在对治疗选择至关重要的问题上的价值观，从而改善了共同决策。
