Department of Nursing, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, No. 700 Moyu Road, Jiading District, Shanghai, 201805, People's Republic of China.
Officers' Ward, General Hospital of Northern Theater Command, Shenyang, 110016, Liaoning, People's Republic of China.
BMC Med Inform Decis Mak. 2022 May 31;22(1):145. doi: 10.1186/s12911-022-01883-w.
It is well known that decision aids can promote patients' participation in decision-making, increase patients' decision preparation and reduce decision conflict. The goal of this study is to explore the effects of a "Shared Decision Making Assistant" smartphone application on the decision-making of informed patients with Primary Liver Cancer (PLC) in China.
In this quasi-experimental study , 180 PLC patients who knew their real diagnoses in the Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China, from April to December 2020 were randomly assigned to a control group and an intervention group. Patients in the intervention group had an access to the "Shared Decision Making Assistant" application in decision-making, which included primary liver cancer treatment knowledge, decision aids path, continuing nursing care video clips, latest information browsing and interactive platforms. The study used decision conflict scores to evaluate the primary outcome, and the data of decision preparation, decision self-efficacy, decision satisfaction and regret, and knowledge of PLC treatment for secondary outcomes. Then, the data were entered into the SPSS 22.0 software and were analyzed by descriptive statistics, Chi-square, independent t-test, paired t-test, and Mann-Whitney tests.
Informed PLC patients in the intervention group ("SDM Assistant" group) had significantly lower decision conflict scores than those in the control group. ("SDM Assistant" group: 16.89 ± 8.80 vs. control group: 26.75 ± 9.79, P < 0.05). Meanwhile, the decision preparation score (80.73 ± 8.16), decision self-efficacy score (87.75 ± 6.87), decision satisfaction score (25.68 ± 2.10) and knowledge of PLC treatment score (14.52 ± 1.91) of the intervention group were significantly higher than those of the control group patients (P < 0.05) at the end of the study. However, the scores of "regret of decision making" between the two groups had no statistical significance after 3 months (P > 0.05).
Access to the "Shared Decision Making Assistant" enhanced the PLC patients' performance and improved their quality of decision making in the areas of decision conflict, decision preparation, decision self-efficacy, knowledge of PLC treatment and satisfaction. Therefore, we recommend promoting and updating the "Shared Decision Making Assistant" in clinical employment and future studies.
众所周知，决策辅助工具可以促进患者参与决策，增加患者的决策准备并减少决策冲突。本研究的目的是探讨智能手机应用“共同决策助手”对中国原发性肝癌（PLC）知情患者决策的影响。
在这项准实验研究中，2020 年 4 月至 12 月期间，在中国海军军医大学东方肝胆外科医院，180 名知晓真实诊断的 PLC 患者被随机分配到对照组和干预组。干预组患者在决策时可以使用“共同决策助手”应用程序，该应用程序包括原发性肝癌治疗知识、决策辅助路径、持续护理视频剪辑、最新信息浏览和互动平台。本研究使用决策冲突评分评估主要结局，使用决策准备、决策自我效能、决策满意度和后悔、以及 PLC 治疗知识评估次要结局。然后，将数据输入到 SPSS 22.0 软件中，并通过描述性统计、卡方检验、独立 t 检验、配对 t 检验和曼-惠特尼检验进行分析。
干预组（“SDM 助手”组）的知情 PLC 患者的决策冲突评分明显低于对照组。（“SDM 助手”组：16.89±8.80 与对照组：26.75±9.79，P<0.05）。同时，干预组的决策准备评分（80.73±8.16）、决策自我效能评分（87.75±6.87）、决策满意度评分（25.68±2.10）和 PLC 治疗知识评分（14.52±1.91）均明显高于对照组（P<0.05）。然而，两组患者在 3 个月后“决策后悔”评分无统计学意义（P>0.05）。
使用“共同决策助手”增强了 PLC 患者的表现，并在决策冲突、决策准备、决策自我效能、PLC 治疗知识和满意度等方面提高了他们的决策质量。因此，我们建议在临床工作和未来研究中推广和更新“共同决策助手”。
