Med Decis Making - Measuring informed decision making about prostate cancer screening in primary care.

Tópicos

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Resumo

RPOSE: To measure the extent of informed decision making (IDM) about prostate cancer screening in physician-patient encounters, describe the coding process, and assess the reliability of the IDM measure.METHODS: Audiorecoded encounters of 146 older adult men and their primary care physicians were obtained in a randomized controlled trial of mediated decision support related to prostate cancer screening. Each encounter was dual coded for the presence or absence of 9 elements that reflect several important dimensions of IDM, such as information sharing, patient empowerment, and engaging patients in preference clarification. An IDM-9 score (range = 0-9) was determined for each encounter by summing the number of elements that were coded as present. Estimates of coding reliability and internal consistency were calculated.RESULTS: Male patients tended to be white (59%), married (70%), and between the ages of 50 and 59 (70%). Physicians tended to be white (90%), male (74%), and have more than 10 years of practice experience (74%). IDM-9 scores ranged from 0 to 7.5 (mean [SD], 2.7 [2.1]). Reliability (0.90) and internal consistency (0.81) of the IDM-9 were both high. The IDM dimension observed most frequently was information sharing (74%), whereas the dimension least frequently observed was engagement in preference clarification (3.4%).CONCLUSIONS: In physician-patient encounters, the level of IDM concerning prostate cancer screening was low. The use of a dual-coding approach with audiorecorded encounters produced a measure of IDM that was reliable and internally consistent.

Resumo Limpo

rpose measur extent inform decis make idm prostat cancer screen physicianpati encount describ code process assess reliabl idm measuremethod audiorecod encount older adult men primari care physician obtain random control trial mediat decis support relat prostat cancer screen encount dual code presenc absenc element reflect sever import dimens idm inform share patient empower engag patient prefer clarif idm score rang determin encount sum number element code present estim code reliabl intern consist calculatedresult male patient tend white marri age physician tend white male year practic experi idm score rang mean sd reliabl intern consist idm high idm dimens observ frequent inform share wherea dimens least frequent observ engag prefer clarif conclus physicianpati encount level idm concern prostat cancer screen low use dualcod approach audiorecord encount produc measur idm reliabl intern consist

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