Rothert M L, Holmes-Rovner M, Rovner D, Kroll J, Breer L, Talarczyk G, Schmitt N, Padonu G, Wills C
College of Nursing, Michigan State University, East Lansing 48824-1317, USA.
Res Nurs Health. 1997 Oct;20(5):377-87. doi: 10.1002/(sici)1098-240x(199710)20:5<377::aid-nur2>3.0.co;2-l.
The purpose of this study was to develop and test a decision support intervention (DSI) to assist women to make and act on informed decisions that are consistent with their values in the area of menopause and hormone replacement therapy (HRT). Mode and intensity of intervention were tested in midlife women (N = 248), randomly assigned to one of three intervention formats: written information only, guided discussion, or personalized decision exercise. Data were collected over 12 months. Knowledge, decisional conflict, satisfaction with health care provider, and self-efficacy improved following intervention and were maintained for 12 months for all groups. Women's adherence to their own plans over 12 months was 59% (exercise), 76% (calcium intake), and 89% (HRT). Carefully written information is effective in promoting knowledge, adherence, and satisfaction among well-educated, interested women. It was concluded that women can understand complex information, including tradeoffs regarding treatment options. Women will adhere to their own plans, suggesting that consumer rather than provider plans may be the more appropriate gold standard for measuring adherence.
本研究的目的是开发并测试一种决策支持干预措施（DSI），以帮助女性做出符合其在更年期和激素替代疗法（HRT）领域价值观的明智决策并付诸行动。在中年女性（N = 248）中测试了干预的方式和强度，她们被随机分配到三种干预形式之一：仅书面信息、引导式讨论或个性化决策练习。数据收集持续了12个月。干预后，所有组的知识水平、决策冲突、对医疗保健提供者的满意度和自我效能均有所提高，并在12个月内保持稳定。女性在12个月内对自身计划的依从性分别为59%（练习）、76%（钙摄入）和89%（HRT）。精心编写的信息对于提高受过良好教育且感兴趣的女性的知识水平、依从性和满意度是有效的。研究得出结论，女性能够理解复杂信息，包括关于治疗选择的权衡。女性会坚持自己的计划，这表明消费者而非提供者的计划可能是衡量依从性更合适的金标准。
