Kuo Hoi-Chen, Lee Wen-Ying, Hsu Hui-Chun, Creedy Debra K, Tsao Ying
Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
School of Nursing & Midwifery, Griffith University, Nathan, Australia.
Nutr Cancer. 2024;76(4):325-334. doi: 10.1080/01635581.2024.2307649. Epub 2024 Feb 7.
This study aimed to examine the effects of an animated Patient Decision Aid (PtDA) about dietary choices on decisional conflict and decision regret. A prospective, observational, two-group comparative effectiveness study was conducted with patients ( = 90) from a southern Taiwan oncology inpatient unit. Data included the Malnutrition Universal Screening Tool (MUST), laboratory results, 16-item Decisional Conflict Scale (sf-DCS), and 5-item Decision Regret Scale (DRSc). Data were collected at admission (T0), after the first-cycle of chemotherapy but before discharge (T1), and after the six-cycle chemotherapy protocol (T2) (around 3 months). Group A received standardized nutrition education and a printed brochure, while Group B watched a 10-minute information video during a one-on-one inpatient consultation and engaged in a values clarification exercise between T0 and T1. The percentage of women with a MUST score ≧1 in Group A sharply increased over time, but not in Group B. Decision aid usage significantly increased patients' hemoglobin and lymphocyte values over time ( < 0.05). The digital PtDA contributed to less decisional conflict and decision regret in at-risk patients and improved their nutritional well-being. Decision-aids help patients make healthcare decisions in line with their values, and are sustainable for use by busy clinicians.
本研究旨在探讨关于饮食选择的动画版患者决策辅助工具(PtDA)对决策冲突和决策后悔的影响。对来自台湾南部肿瘤住院病房的90名患者进行了一项前瞻性、观察性、两组比较有效性研究。数据包括营养不良通用筛查工具(MUST)、实验室检查结果、16项决策冲突量表(sf-DCS)和5项决策后悔量表(DRSc)。在入院时(T0)、化疗第一周期后但出院前(T1)以及六个周期化疗方案后(T2)(约3个月)收集数据。A组接受标准化营养教育和一份印刷手册,而B组在一对一住院咨询期间观看一段10分钟的信息视频,并在T0和T1之间进行价值观澄清练习。A组中MUST评分≧1的女性比例随时间急剧增加,但B组没有。随着时间的推移,使用决策辅助工具显著提高了患者的血红蛋白和淋巴细胞值(<0.05)。数字PtDA有助于减少高危患者的决策冲突和决策后悔,并改善他们的营养状况。决策辅助工具可帮助患者根据自身价值观做出医疗决策,且可供忙碌的临床医生持续使用。