Department of Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Obstetrics and Gynecology, Gelderse Vallei Hospital, Ede, The Netherlands.
Neurourol Urodyn. 2024 Nov;43(8):2052-2059. doi: 10.1002/nau.25578. Epub 2024 Sep 5.
Making a treatment decision for female stress urinary incontinence (SUI) can be challenging for patients and healthcare providers. Dutch guidelines advise to counsel both pelvic floor muscle therapy and midurethral sling surgery as primary treatment options in uncomplicated moderate to severe cases. The use of a patient decision aid (PDA) can support decision-making, reduce decisional conflict and decisional regret, and increase knowledge. The aim of this study was to develop and evaluate an online PDA for females (SUI).
This mixed-methods study was performed in consecutive stages by a multidisciplinary working group. PDA design was based on the International Patient Decision Aids Standards (IPDAS) and on outcomes of needs assessments amongst patients and healthcare providers. Content was based on Dutch guidelines, targeted literature searches and patient information from the Dutch scientific society for gynecology. The concept version was evaluated by patients, patients' advocates, and healthcare providers.
Using the nominal group technique, the working group established the design and format of the PDA. Fifty-six out of 58 applicable items of the IPDAS were met. The PDA contains information on the condition, advice on lifestyle adaptations, and describes surgical and nonsurgical treatment options. The option grid contains comparisons of the primary treatment options. Furthermore, value clarification exercises and narratives were included. Acceptability and usability evaluation of the concept version was performed by 15 healthcare providers, three patients, and two patients' advocates. Comments were processed in the working group, resulting in the final version of the PDA, which was supported by all assessors.
Our multidisciplinary working group developed an online PDA for women with moderate to severe SUI including conservative and surgical treatment options, based on IPDAS criteria, guidelines, scientific evidence, and needs assessments from patients and healthcare providers. This PDA is supported by patients, healthcare providers, scientific societies, and the Dutch patients' association. The next step is to evaluate and implement this PDA in daily practice.
ID 2014-308.
对于女性压力性尿失禁（SUI）患者和医疗保健提供者来说，做出治疗决策可能具有挑战性。荷兰指南建议，在不复杂的中重度病例中，将盆底肌治疗和尿道中段吊带手术作为主要治疗选择进行咨询。使用患者决策辅助工具（PDA）可以支持决策制定，减少决策冲突和决策后悔，并增加知识。本研究旨在开发和评估一种针对女性（SUI）的在线 PDA。
本研究采用多学科工作组的连续阶段进行混合方法研究。PDA 的设计基于国际患者决策辅助工具标准（IPDAS）和患者与医疗保健提供者需求评估的结果。内容基于荷兰指南、目标文献检索和荷兰妇科科学协会的患者信息。概念版本由患者、患者代言人以及医疗保健提供者进行评估。
工作组使用名义小组技术确定了 PDA 的设计和格式。满足了 IPDAS 的 56 个可适用项目中的 58 个。PDA 包含有关病情的信息、生活方式调整建议，并描述了手术和非手术治疗选择。选项网格包含主要治疗选择的比较。此外，还包括价值澄清练习和叙述。概念版本的可接受性和可用性评估由 15 名医疗保健提供者、3 名患者和 2 名患者代言人进行。意见在工作组中进行处理，形成了 PDA 的最终版本，得到了所有评估者的支持。
我们的多学科工作组根据 IPDAS 标准、指南、科学证据以及患者和医疗保健提供者的需求评估，为患有中重度 SUI 的女性开发了一种在线 PDA，其中包括保守和手术治疗选择。该 PDA 得到了患者、医疗保健提供者、科学协会和荷兰患者协会的支持。下一步是在日常实践中评估和实施该 PDA。
ID 2014-308。
