Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, 308 Blockley Hall 423 Guardian Drive, Philadelphia, PA, 19106, USA.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.
BMC Anesthesiol. 2024 May 1;24(1):165. doi: 10.1186/s12871-024-02547-0.
Patients often desire involvement in anesthesia decisions, yet clinicians rarely explain anesthesia options or elicit preferences. We developed My Anesthesia Choice-Hip Fracture, a conversation aid about anesthesia options for hip fracture surgery and tested its preliminary efficacy and acceptability.
We developed a 1-page, tabular format, plain-language conversation aid with feedback from anesthesiologists, decision scientists, and community advisors. We conducted an online survey of English-speaking adults aged 50 and older. Participants imagined choosing between spinal and general anesthesia for hip fracture surgery. Before and after viewing the aid, participants answered a series of questions regarding key outcomes, including decisional conflict, knowledge about anesthesia options, and acceptability of the aid.
Of 364/409 valid respondents, mean age was 64 (SD 8.9) and 59% were female. The proportion indicating decisional conflict decreased after reviewing the aid (63-34%, P < 0.001). Median knowledge scores increased from 50% correct to 67% correct (P < 0.001). 83% agreed that the aid would help them discuss options and preferences. 76.4% would approve of doctors using it.
My Anesthesia Choice-Hip Fracture decreased decisional conflict and increased knowledge about anesthesia choices for hip fracture surgery. Respondents assessed it as acceptable for use in clinical settings.
Use of clinical decision aids may increase shared decision-making; further testing is warranted.
患者通常希望参与麻醉决策，但临床医生很少解释麻醉选择或征求患者的偏好。我们开发了 My Anesthesia Choice-Hip Fracture，这是一种关于髋关节骨折手术麻醉选择的对话辅助工具，并测试了其初步效果和可接受性。
我们开发了一个 1 页的表格格式、通俗易懂的对话辅助工具，该工具得到了麻醉师、决策科学家和社区顾问的反馈。我们对年龄在 50 岁及以上的讲英语的成年人进行了在线调查。参与者想象自己在髋关节骨折手术中选择全身麻醉和脊髓麻醉。在观看辅助工具之前和之后，参与者回答了一系列关于关键结果的问题，包括决策冲突、对麻醉选择的了解以及对辅助工具的可接受性。
在 409 名有效受访者中，364 名的平均年龄为 64（8.9）岁，59%为女性。在查看辅助工具后，表明存在决策冲突的比例从 63%降至 34%（P<0.001）。中位数知识得分从 50%正确提高到 67%正确（P<0.001）。83%的人表示辅助工具将有助于他们讨论选择和偏好。76.4%的人会批准医生使用它。
My Anesthesia Choice-Hip Fracture 降低了髋关节骨折手术的决策冲突，并提高了对麻醉选择的了解。受访者认为该工具在临床环境中使用是可以接受的。
使用临床决策辅助工具可能会增加共同决策；需要进一步测试。
