Med Decis Making - Decision aid influences on factors associated with patient empowerment prior to cancer treatment decision making.

Tópicos

{ decis(3086) make(1611) patient(1517) }
{ intervent(3218) particip(2042) group(1664) }
{ cancer(2502) breast(956) screen(824) }
{ age(1611) year(1155) adult(843) }
{ chang(1828) time(1643) increas(1301) }
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{ process(1125) use(805) approach(778) }
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{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Despite progress, models that incorporate antecedent and mediating factors associated with shared decision making (SDM)-related outcomes remain limited. An experimental study tests patient decision aid (DA) effects on a network of antecedents and mediators associated with patient empowerment prior to a medical decision-making consultation regarding cancer treatment.METHODS: A pilot study initially evaluated measurement scales, model fit, and the overall effect of the DA experience. The pilot compared matched treatment and control group samples of US adult online panel members exposed to a vignette about meeting their dermatologist to decide on skin cancer treatment. The treatment group also experienced a skin cancer DA with treatment options and value clarification activity, while the control group did not. The main study employed a randomized experimental design to formally test hypothesized path coefficients across the groups.RESULTS: The pilot study suggested an overall enhanced DA effect on self-empowerment. In the experimental study, the DA experience strengthened the direct path from desire for medical information to self-empowerment and the indirect path from comprehension/participation confidence to self-empowerment through cancer attitude. The DA had no strengthening effect on the direct path from life satisfaction to self-empowerment, but in the DA condition, the factor appeared to play a role by contributing to the enhanced association between confidence and cancer attitude.CONCLUSION: Evidence from this research indicates that experiencing a DA prior to treatment decision making affects patient empowerment through a network that includes desire for information, life satisfaction, and multiple mediators. The studies also demonstrate the role that theory-based, multigroup structural equation modeling (SEM) can play in increasing understanding of DA effects. Such understanding is critical to improving SDM between patients and their physicians.

Resumo Limpo

ckground despit progress model incorpor anteced mediat factor associ share decis make sdmrelat outcom remain limit experiment studi test patient decis aid da effect network anteced mediat associ patient empower prior medic decisionmak consult regard cancer treatmentmethod pilot studi initi evalu measur scale model fit overal effect da experi pilot compar match treatment control group sampl us adult onlin panel member expos vignett meet dermatologist decid skin cancer treatment treatment group also experienc skin cancer da treatment option valu clarif activ control group main studi employ random experiment design formal test hypothes path coeffici across groupsresult pilot studi suggest overal enhanc da effect selfempower experiment studi da experi strengthen direct path desir medic inform selfempower indirect path comprehensionparticip confid selfempower cancer attitud da strengthen effect direct path life satisfact selfempower da condit factor appear play role contribut enhanc associ confid cancer attitudeconclus evid research indic experienc da prior treatment decis make affect patient empower network includ desir inform life satisfact multipl mediat studi also demonstr role theorybas multigroup structur equat model sem can play increas understand da effect understand critic improv sdm patient physician

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