Med Decis Making - The impact of explicit values clarification exercises in a patient decision aid emerges after the decision is actually made: evidence from a randomized controlled trial.

Tópicos

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Resumo

RPOSE: To determine if particular values clarification exercises included in a patient decision aid had discernible impact on postdecisional regret in patients with early-stage prostate cancer.METHODS: A multicenter randomized controlled trial compared 2 versions of a computerized patient decision aid: only structured information compared to the structured information plus values clarification exercises. Assessments were conducted during the decision aid visit; telephone follow-up interviews were conducted when patients made their decisions with their physician, 3 months after completing treatment, and >1 year later (per a mailing). Outcome measures included the Decisional Conflict Scale, the Preparation for Decision Making Scale, and the Decision Regret Scale.RESULTS: A total of 156 patients participated, 75 provided information only and 81 provided information plus values clarification exercises. The groups did not differ significantly on any outcome evaluated at the decision aid visit; in both groups, decisional conflict decreased immediately after using the decision aid. Between-group differences emerged after the decision was actually made. The values clarification exercises group reported higher Preparation for Decision Making Scale scores at the decision follow-up and at the >1-year follow-up. Regret did not differ significantly between groups at the 3-month follow-up but was lower for the values clarification exercises group than for the information group at the >1-year follow-up.CONCLUSION: The results suggest that the values clarification exercises led to better preparation for decision making and to less regret. The impact, however, only emerged after the decision was made.

Resumo Limpo

rpose determin particular valu clarif exercis includ patient decis aid discern impact postdecision regret patient earlystag prostat cancermethod multicent random control trial compar version computer patient decis aid structur inform compar structur inform plus valu clarif exercis assess conduct decis aid visit telephon followup interview conduct patient made decis physician month complet treatment year later per mail outcom measur includ decision conflict scale prepar decis make scale decis regret scaleresult total patient particip provid inform provid inform plus valu clarif exercis group differ signific outcom evalu decis aid visit group decision conflict decreas immedi use decis aid betweengroup differ emerg decis actual made valu clarif exercis group report higher prepar decis make scale score decis followup year followup regret differ signific group month followup lower valu clarif exercis group inform group year followupconclus result suggest valu clarif exercis led better prepar decis make less regret impact howev emerg decis made

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