Background
Methods
Step 1 – baseline status on SDM practice
Step 2 - development of a patient decision aid for LDH
Step 3 - alpha-test with potential users
Step 4 – pilot test in the clinic
Results
Step 1 – baseline status on SDM practice
Result | Interpretation | |
---|---|---|
DQW-HD (knowledge), (mean (SD)) | 42.69 (19,3) | 0 = No knowledge 100 = Best possible knowledge |
DQW-HD (Decision process), (mean (SD)) | 76.39 (22,75) | 0 = No engagement in the decision 100 = Best possible engagement in the decision |
DCS, (mean (SD)) | 18 (12,41) | 0 = No Decisional conflict 100 = Extreme decisional conflict |
DCS, (n (%)): score < 25 score 25–37.5 score > 37.5 | 25 (64.1) 11 (28.2) 3 (7.7) | Scores lower than 25 are associated with implementing decisions. Scores beyond 37.5 are associated with decision delay or feeling unsure about the decision. |
CollaboRATE, (mean (SD)) | 8.45 (1,01) | 1 = No effort was made 9 = Every effort was made |
CollaboRATE top score (%)a | 63,16 | 0 = No SDM 100 = Gold standard of SDM |
Step 2 – development/adaption of patient decision aid for LDH
Age | |
30–39 | 3 |
40–49 | 1 |
50–59 | 2 |
> 60 | 4 |
Gender | |
Male | 3 |
Female | 7 |
Highest level of education | |
College degree | 3 |
Vocational education | 6 |
Unknown | 1 |
Experience with lumbar disc herniation | |
Surgery for lumbar disc herniation | 5 |
No surgery | 4 |
Relative of patient with lumbar disc herniation | 1 |
Step 3 - alpha-test with potential users
Acceptability and usability | Stronglyagree | Agree | Neither agree or disagree | Dis-agree | Stronglydis-agree |
---|---|---|---|---|---|
The purpose of the decision aid is clear | 4 | 6 | |||
It is clear that I can chose how much information I want | 4 | 5 | 1 | ||
It is clear that I can state/discuss what worries me most | 2 | 6 | 1 | 1 | |
The benefits and harms of each option is clear to me | 7 | 3 | |||
It is clear that I have to make a choice | 5 | 5 | |||
Preparation for decision–making | Not at all | A little | Some-what | Quite a bit | A great deal |
Help patient recognize a decision needs to be made | 1 | 4 | 5 | ||
Prepare patient to make a better decision | 1 | 5 | 4 | ||
Help patients think about the pros/cons of options | 4 | 6 | |||
Help patients think about which pros/cons are most important | 8 | 2 | |||
Help patients know that the decision depends on what matters most to them | 1 | 7 | 2 | ||
Help patients to organize their own thoughts about the decision | 1 | 4 | 5 | ||
Help patients think about how much they want to be a part of the decision | 1 | 1 | 2 | 5 | |
Help patients ask questions and discuss them with the doctor. | 2 | 1 | 4 | 2 |
Qualitative findings
Lines under the text in section 3, where important personal issues could be noted.
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Use the inner side of the frame (section 4) and the back.
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Add worries about the future in card 3.
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A good help afterwards to support the decision made.
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Nice to have the information visualized.
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Miss the timeline of no-surgery treatment.
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A bit too long text in section 3 of the frame.
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How fast is “faster withdrawal from pain medication”?
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