Noordman Janneke, Noordam Désanne, van Treeck Jorien, Prantl Karen, Pennings Patricia, Borsje Petra, Heinen Maud, Emond Yvette, Rake Ester, Boland Gudule, van Dulmen Sandra
Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
PLoS One. 2024 Dec 3;19(12):e0314732. doi: 10.1371/journal.pone.0314732. eCollection 2024.
It is unknown how visual decision aids support communication and shared decision-making in everyday clinical practice, and how they are perceived by patients with varying levels of health literacy and their healthcare providers. Recently, three visual decision aids have been developed for renal replacement treatment, osteoarthritis of the knee, and osteoarthritis of the hip. This study aims to explore how patients and healthcare providers use and value these visual decision aids.
The evaluation of the visual decision aids was performed by coding video-recorded outpatient consultations (n = 35), by conducting reflective practice interviews with healthcare providers (n = 9), and through interviews with patients (n = 29). Consultations were coded using the 5-item OPTION instrument to measure shared decision-making, and self-developed items based on the visual decision aids and user guide.
Both healthcare providers and patients valued the use of the visual decision aids, especially the overview page with all treatment options. Accordingly, it was observed that most providers mainly used the overview page. However, providers in nephrology discussed the individual treatment pages more often than providers in osteoarthritis care. This study also showed that most providers were unfamiliar with the user guide for the visual decision aids.
Visual decision aids for nephrology and osteoarthritis care seem particularly useful for patients with limited health literacy. Healthcare providers in this study mainly used the overview page of the visual decision aids. Although this is valued by both providers and patients, it is also important to discuss the individual treatment pages, including the pros and cons, with patients. This study also points to differences between outpatient clinics or departments in the use and implementation of the visual decision aids. The visual decision aids for osteoarthritis are used to a limited extent. In nephrology clinics, the visual decision aid is implemented.
尚不清楚视觉决策辅助工具如何在日常临床实践中支持沟通和共同决策，以及不同健康素养水平的患者及其医疗服务提供者如何看待这些工具。最近，已开发出三种针对肾脏替代治疗、膝关节骨关节炎和髋关节骨关节炎的视觉决策辅助工具。本研究旨在探讨患者和医疗服务提供者如何使用这些视觉决策辅助工具以及对其的重视程度。
通过对门诊咨询视频记录（n = 35）进行编码、对医疗服务提供者进行反思性实践访谈（n = 9）以及对患者进行访谈（n = 29）来评估视觉决策辅助工具。使用5项OPTION工具对咨询进行编码以衡量共同决策，并根据视觉决策辅助工具和用户指南自行开发项目。
医疗服务提供者和患者都重视视觉决策辅助工具的使用，尤其是包含所有治疗选项的概述页面。因此，观察到大多数提供者主要使用概述页面。然而，肾脏病科的提供者比骨关节炎护理科的提供者更频繁地讨论各个治疗页面。本研究还表明，大多数提供者不熟悉视觉决策辅助工具的用户指南。
肾脏病和骨关节炎护理的视觉决策辅助工具对健康素养有限的患者似乎特别有用。本研究中的医疗服务提供者主要使用视觉决策辅助工具的概述页面。尽管这受到提供者和患者双方的重视，但与患者讨论各个治疗页面，包括利弊，也很重要。本研究还指出了门诊诊所或科室在视觉决策辅助工具的使用和实施方面存在差异。骨关节炎的视觉决策辅助工具使用程度有限。在肾脏病诊所，视觉决策辅助工具已得到实施。
