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Said CM, Ramage E, McDonald CE, Bicknell E, Hitch D, Fini NA, Bower KJ, Lynch E, Vogel AP, English K, McKay G, English C. Co-designing resources for rehabilitation via telehealth for people with moderate to severe disability post stroke. Physiotherapy 2024; 123:109-117. [PMID: 38458033 DOI: 10.1016/j.physio.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES The COVID-19 pandemic necessitated rapid transition to telehealth. Telehealth presents challenges for rehabilitation of stroke survivors with moderate-to-severe physical disability, which traditionally relies on physical interactions. The objective was to co-design resources to support delivery of rehabilitation via telehealth for this cohort. DESIGN Four-stage integrated knowledge translation co-design approach. Stage 1: Research team comprising researchers, clinicians and stroke survivors defined the research question and approach. Stage 2: Workshops and interviews were conducted with knowledge users (participants) to identify essential elements of the program. Stage 3: Resources developed by the research team. Stage 4: Resources reviewed by knowledge users and adapted. PARTICIPANTS Twenty-one knowledge users (clinicians n = 11, stroke survivors n = 7, caregivers n = 3) RESULTS: All stakeholders emphasised the complexities of telehealth rehabilitation for stroke and the need for individualised programs. Shared decision-making was identified as critical. Potential risks and benefits of telehealth were acknowledged and strategies to ameliorate risks and deliver effective rehabilitation were identified. Four freely available online resources were co-designed; three resources to support clinicians with shared decision-making and risk management and a decision-aid to support stroke survivors and caregivers throughout the process. Over six months, 1129 users have viewed the webpage; clinician resources were downloaded 374 times and the decision-aid was downloaded 570 times. CONCLUSIONS The co-design process identified key elements for delivery of telehealth rehabilitation to stroke survivors with moderate-to-severe physical disability and led to development of resources to support development of an individualised telehealth rehabilitation plan. Future research should evaluate the effectiveness of these resources. CONTRIBUTION OF PAPER.
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Affiliation(s)
- Catherine M Said
- Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; Physiotherapy, Western Health, St Albans, Australia; Australian Institute of Musculoskeletal Sciences, St Albans, Australia.
| | - Emily Ramage
- Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; Physiotherapy, Western Health, St Albans, Australia; School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Australia; Allied Health Strategy, Planning, Innovation, Research and Education Unit, Western Health, St Albans, Australia.
| | - Cassie E McDonald
- Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; Physiotherapy, The Royal Melbourne Hospital, Parkville, Australia; Allied Health, Alfred Health, Melbourne, Australia.
| | - Erin Bicknell
- Physiotherapy, Western Health, St Albans, Australia; Physiotherapy, The Royal Melbourne Hospital, Parkville, Australia.
| | - Danielle Hitch
- Allied Health Strategy, Planning, Innovation, Research and Education Unit, Western Health, St Albans, Australia; School of Health and Social Development, Deakin University, Geelong, Australia.
| | - Natalie A Fini
- Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia.
| | - Kelly J Bower
- Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia.
| | - Elizabeth Lynch
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.
| | - Adam P Vogel
- Audiology and Speech Pathology, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; Redenlab Inc, Melbourne, Australia.
| | | | - Gary McKay
- Consumer Representative, Melbourne, Australia.
| | - Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Australia.
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Hopkins L, Carey M, Brown L, McCrea S, Milne M, Tokaryk D, Stacey D. The Development and Testing of a Patient Decision Aid for Individuals with Homologous Recombinant Proficient Ovarian Cancer Who Are Considering Niraparib Maintenance Therapy. Curr Oncol 2024; 31:1416-1425. [PMID: 38534940 PMCID: PMC10969309 DOI: 10.3390/curroncol31030107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 05/26/2024] Open
Abstract
New treatments for ovarian cancer are available that require trade-offs between progression-free survival and quality of life. The aim of this study was to develop a decision aid for patients with homologous recombinant proficient (HRP) tumors, as the benefit-harm ratio of niraparib needs consideration. This decision aid was created with a systematic and iterative development process based on the Ottawa Decision Support Framework. The decision aid was user-tested for acceptability, usability, and comprehensibility using a survey completed by a sample of patients with ovarian cancer and oncologists. This decision aid follows the International Patient Decision Aids Standards (IPDAS) criteria in its development. User-test respondents (n = 13 patients; 13 physicians) reported that the decision aid used language that was easy to follow (69% patients; 85% physicians), was an appropriate length (69% patients; 62% physicians) and provided the right amount of information (54% patients; 54% physicians). Most respondents (92% patients; 62% physicians) would recommend this decision aid for HRP patients considering niraparib. This is the first decision aid for patients with HRP ovarian cancers who are considering niraparib maintenance therapy. It is available on-line and is being further evaluated in a pragmatic clinical trial in Saskatchewan.
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Affiliation(s)
- Laura Hopkins
- Division of Oncology, University of Saskatchewan, Saskatoon, SK S7V 4H4, Canada
| | - Mark Carey
- Division of Gynecologic Oncology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Linda Brown
- Ovarian Cancer Canada, Toronto, ON M5A 1E3, Canada
| | - Sabryna McCrea
- Research Facilitators, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada; (S.M.); (M.M.)
| | - Mark Milne
- Research Facilitators, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada; (S.M.); (M.M.)
| | - Dawne Tokaryk
- Saskatchewan Cancer Agency Patient and Family Advisory Council, Saskatoon, SK S7V 4H4, Canada;
| | - Dawn Stacey
- School of Nursing Science, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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Guay-Bélanger S, Aubin E, Cimon M, Archambault P, Blanchette V, Giguere A, Gogovor A, Morin M, Ben Charif A, Ben Gaied N, Bickerstaff J, Chénard N, Emond J, Gilbert J, Violet I, Légaré F. Engagement of Older Adults Receiving Home Care Services and Their Caregivers in Health Decisions in Partnership With Clinical Teams: Protocol for a Multimethod Study to Prioritize and Culturally Adapt Decision Aids for Home Care. JMIR Res Protoc 2023; 12:e53150. [PMID: 37889512 PMCID: PMC10696497 DOI: 10.2196/53150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Older adults (people aged 65 years and older) face many difficult decisions. Patient decision aids (PtDAs) can help them and their families make informed value-congruent decisions. Some PtDAs have been developed for the home care context, but little is known about scaling them for use with older adults in a different culture. OBJECTIVE This study aims to (1) assess the scalability of existing PtDAs for older adults in the home care context; (2) prioritize those that best match the decisional needs of older adults in home care; and (3) culturally adapt the prioritized PtDAs so they can be scaled successfully to the Quebec health care system. METHODS This multimethod study includes 3 phases. All phases will be overseen by a steering committee of older adults, caregivers, health professionals, decision makers, community organization representatives, and researchers with the needed expertise. In phase 1, we will use the Innovation Scalability Self-administered Questionnaire, a validated scalability self-assessment tool, to assess the scalability of 33 PtDAs previously identified in a systematic review. Based on their scalability, their quality (based on the International Patient Decision Aids Standards), and the importance of the decision point, we will retain approximately a third of these. In phase 2, we will conduct a 2-round web-based Delphi to prioritize the PtDAs selected in phase 1. Using a snowball recruitment strategy, we aim to recruit 60 Delphi participants in the province of Quebec, including older adults, caregivers, health professionals, decision makers involved in home care services, and PtDA experts. In the first round, we will ask participants to rate the importance of several PtDA decision points according to various criteria such as prevalence and difficulty on a 5-point Likert scale (1=not important to 5=very important). Approximately 6 of the highest-rated PtDAs will be retained for presentation in the second round, and we will select up to 3 PtDAs judged as having the highest priority for cultural adaptation. In phase 3, using the Chenel framework and user-centered design methods, we will update and adapt the PtDAs to the Quebec health care system and integrate these PtDAs into an interprofessional shared decision-making training program for home care teams. The adapted PtDAs will respect the International Patient Decision Aids Standards criteria. RESULTS This study was funded in March 2022 by the Canadian Institutes of Health Research. Data collection for the web-based Delphi began in October 2023. Results are expected to be published in May 2024. CONCLUSIONS This project will provide relevant and culturally appropriate decision support tools for older adults making difficult decisions and their home care teams that will be ready for scaling across the province of Quebec. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/53150.
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Affiliation(s)
- Sabrina Guay-Bélanger
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Emmanuelle Aubin
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Marie Cimon
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Patrick Archambault
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
- Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
- Department of Anesthesiology and Intensive Care, Université Laval, Quebec, QC, Canada
| | - Virginie Blanchette
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Anik Giguere
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Amédé Gogovor
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Michèle Morin
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
- Department of Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | | | | | | | - Nancy Chénard
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Julie Emond
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Julie Gilbert
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Isabelle Violet
- Ministère de la santé et des services sociaux du Québec, Quebec, QC, Canada
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
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Kiss A, Zhang Q, Carley M, Smith M, Légaré F, Archambault P, Stacey D. Quality of patient decision aids to support the public making COVID-19 decisions: An online environmental scan. PATIENT EDUCATION AND COUNSELING 2023; 114:107797. [PMID: 37244134 PMCID: PMC10197540 DOI: 10.1016/j.pec.2023.107797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/03/2023] [Accepted: 05/16/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To identify and appraise the quality of COVID-19 patient decision aids (PtDAs). METHODS We conducted an environmental scan of online publicly available COVID-19 PtDAs. Two reviewers independently searched and extracted data. We calculated median International Patient Decision Aid Standards (IPDAS) scores and proportion scoring > 70% on Patient Education Materials Information Tool (PEMAT) adequate for understandability and actionability. RESULTS Of 876 resources identified, 12 were PtDAs. Decisions focused on initial COVID-19 vaccination series (n = 9), location of care for elderly (n = 2), and social distancing (n = 1). All 12 PtDAs were written materials and two had accompanying videos. The median IPDAS score minimizing risk of biased decisions was 4 of 6 items (IQR 1, range 2-4). For PEMAT, 92% had adequate for understandability and none for actionability. CONCLUSIONS We identified few online publicly available COVID-19 PtDAs and none were about COVID-19 vaccination boosters or treatment. PtDAs scored poorly on actionability and none met all IPDAS criteria for minimizing risk of biased decisions. PRACTICE IMPLICATIONS PtDA developers for COVID-19 and future pandemics should ensure their PtDAs meet all IPDAS criteria for minimizing risk of bias, have adequate scores for actionability, and are disseminated in the A to Z inventory.
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Affiliation(s)
- Alda Kiss
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada
| | - Qian Zhang
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada
| | - Meg Carley
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Maureen Smith
- Patient Partner and Cochrane Consumer Network Executive, Ottawa, Canada
| | - France Légaré
- VITAM-Centre de recherche en santé durable, Pavillon Landry-Poulin, Québec, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Québec, Canada; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Université Laval, Québec, Canada
| | - Patrick Archambault
- Centre de Recherche Intégrée Pour un Système Apprenant en Santé et Services Sociaux, Lévis, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Lévis, Canada; VITAM - Centre de Recherche en Santé Durable, Québec, Canada
| | - Dawn Stacey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
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Ivankovic V, McAlpine K, Delic E, Carrier M, Stacey D, Auer RC. Extended‐duration thromboprophylaxis for abdominopelvic surgery: Development and evaluation of a risk‐stratified patient decision aid to facilitate shared decision making. Res Pract Thromb Haemost 2022; 6:e12831. [PMID: 36397933 PMCID: PMC9663316 DOI: 10.1002/rth2.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/02/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Extended-duration thromboprophylaxis is used to decrease risk of venous thromboembolism (VTE) after surgery but may increase the risk of bleeding. The decision to complete a course of extended-duration thromboprophylaxis can be challenging. Objective The objective of this study was to develop an acceptable patient decision aid (PtDA) to facilitate shared decision making for the use of extended-duration thromboprophylaxis following major abdominal surgery. Methods An evidence-based, risk-stratified PtDA was created. The evidence on benefits and harms of a 28-day postoperative course of low-molecular-weight heparin (LMWH) versus in-hospital prophylaxis only were synthesized. Outcomes included minor bleeding, major bleeding, clinically significant VTE, and fatal VTE. Risks were calculated and reported by Caprini score. Alpha testing of the PtDA draft with various stakeholders was performed using a 10-question survey to assess acceptability of the PtDA with patients, thrombosis experts, and surgeons. The primary outcome was the acceptability of the PtDA. Results Acceptability testing was performed with 11 patients, 11 thrombosis experts, and 11 surgeons. Most responders felt the language on the PtDA was easy to follow (28/33, 85%), and that the information was well balanced between management options (9/11 [82%] patients; 17/21 [80%] clinicians). Most patients (9/11, 82%) and clinicians (18/22, 82%) believed it would be a useful clinical tool, and were satisfied with the overall quality of the PtDA (27/33, 82%). Conclusions A risk-stratified, evidence-based PtDA was created to facilitate shared decision making for the use of extended-duration LMWH following major abdominal surgery. This clinical tool was acceptable with patients and physicians and is available at https://decisionaid.ohri.ca/decaids.html.
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Affiliation(s)
| | - Kristen McAlpine
- Division of Urology, Department of Surgery University of Toronto Toronto Ontario Canada
| | - Edita Delic
- Department of Surgery, University of Ottawa The Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Marc Carrier
- Department of Medicine University of Ottawa The Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Dawn Stacey
- School of Nursing, University of Ottawa Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Rebecca C. Auer
- Department of Surgery, University of Ottawa The Ottawa Hospital Research Institute Ottawa Ontario Canada
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Barry MJ, Härter M, Househ M, Steffensen KD, Stacey D. What can we learn from rapidly developed patient decision aids produced during the covid-19 pandemic? BMJ 2022; 378:e071530. [PMID: 36175019 PMCID: PMC9518003 DOI: 10.1136/bmj-2022-071530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Supporting people to make decisions during the covid-19 pandemic created new opportunities for shared decision making and rapid development of patient decision aids, say Michael Barry and colleagues
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Affiliation(s)
- Michael J Barry
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Martin Härter
- Department of Medical Psychology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Germany
- Agency for Quality in Medicine, Berlin, Germany
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Karina Dahl Steffensen
- Center for Shared Decision Making, Vejle/Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Dawn Stacey
- University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Lognon T, Plourde KV, Aubin E, Giguere AMC, Archambault PM, Stacey D, Légaré F. Decision aids for home and community care: a systematic review. BMJ Open 2022; 12:e061215. [PMID: 36129731 PMCID: PMC9362828 DOI: 10.1136/bmjopen-2022-061215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Decision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to identify DAs developed for home and community care, verify their adherence to international DA criteria and explore the involvement of interprofessional teams in their development and use. DESIGN Systematic review reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Six electronic bibliographic databases (MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO and the Cochrane Library) from inception to November 2019, social media and grey literature websites up to January 2021. ELIGIBILITY CRITERIA DAs designed for home and community care settings or including home care or community services as options. DATA EXTRACTION AND SYNTHESIS Two reviewers independently reviewed citations. Analysis consisted of a narrative synthesis of outcomes and a thematic analysis. DAs were appraised using the International Patient Decision Aid Standards (IPDAS). We collected information on the involvement of interprofessional teams, including nurses, in their development and use. RESULTS After reviewing 10 337 database citations and 924 grey literature citations, we extracted characteristics of 33 included DAs. DAs addressed a variety of decision points. Nearly half (42%) were relevant to older adults. Several DAs did not meet IPDAS criteria. Involvement of nurses and interprofessional teams in the development and use of DAs was minimal (33.3% of DAs). CONCLUSION DAs concerned a variety of decisions, especially those related to older people. This reflects the complexity of decisions and need for better support in this sector. There is little evidence about the involvement of interprofessional teams in the development and use of DAs in home and community care settings. An interprofessional approach to designing DAs for home care could facilitate SDM with people being cared for by teams. PROSPERO REGISTRATION NUMBER CRD42020169450.
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Affiliation(s)
- Tania Lognon
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
- VITAM-Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
| | - Karine V Plourde
- VITAM-Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
| | - Emmanuelle Aubin
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Patient-partner, Quebec, Quebec, Canada
| | - Anik M C Giguere
- VITAM-Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Quebec Centre for Excellence on Aging, Quebec, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Patrick M Archambault
- VITAM-Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Quebec, Canada
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Dawn Stacey
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Patient Decision Aids Research Group, Ottawa, Ontario, Canada
| | - France Légaré
- VITAM-Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
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Toi AK, Ben Charif A, Lai C, Ngueta G, Plourde KV, Stacey D, Légaré F. Difficult Decisions for Older Canadians Receiving Home Care, and Why They Are So Difficult: A Web-Based Decisional Needs Assessment. MDM Policy Pract 2022; 7:23814683221124090. [PMID: 36132436 PMCID: PMC9483974 DOI: 10.1177/23814683221124090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/01/2022] [Indexed: 12/01/2022] Open
Abstract
Background. Older adults receiving home care services often face
decisions related to aging, illness, and loss of autonomy. To inform tailored
shared decision making interventions, we assessed their decisional needs by
asking about the most common difficult decisions, measured associated decisional
conflict, and identified factors associated with it. Methods. In
March 2020, we conducted a cross-sectional survey with a pan-Canadian Web-based
panel of older adults (≥65 y) receiving home care services. For a difficult
decision they had faced in the past year, we evaluated clinically significant
decisional conflict (CSDC) using the 16-item Decisional Conflict Scale (score
0–100) with a >37.5 cutoff. To identify factors associated with CSDC, we
performed descriptive, bivariable, and multivariable analyses using the stepwise
selection method with an assumed entry and exit significance level of 0.15 and
0.20, respectively. Final model selection was based on the Bayesian information
criterion. Results. Among 460 participants with an average age of
72.5 y, difficult decisions were, in order of frequency, about housing and
safety (57.2%), managing health conditions (21.8%), and end-of-life care (8.3%).
CSDC was experienced by 14.6% (95% confidence interval [CI]: 11.5%, 18.1%) of
respondents on all decision points. Factors associated with CSDC included
household size = 1 (OR [95% CI]: 1.81 [0.99, 3.33]; P = 0.27),
household size = 3 (2.66 [0.78, 8.98]; P = 0.83), and household
size = 4 (6.91 [2.23, 21.39]; P = 0.014); preferred option not
matching the decision made (4.05 [2.05, 7.97]; P < 0.001);
passive role in decision making (5.13 [1.78, 14.77]; P =
0.002); and lower quality of life (0.70 [0.57, 0.87];
P<0.001). Discussion. Some older adults
receiving home care services in Canada experience CSDC when facing difficult
decisions. Shared decision-making interventions could mitigate associated
factors.
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Affiliation(s)
- Alfred Kodjo Toi
- VITAM–Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
| | - Ali Ben Charif
- VITAM–Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
| | - Claudia Lai
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - Gérard Ngueta
- VITAM–Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Karine V. Plourde
- VITAM–Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
| | - Dawn Stacey
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Patient Decision Aids Research Group, Clinical Epidemiology Program, Ottawa, ON, Canada
| | - France Légaré
- VITAM–Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada
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Lognon T, Gogovor A, Plourde KV, Holyoke P, Lai C, Aubin E, Kastner K, Canfield C, Beleno R, Stacey D, Rivest LP, Légaré F. Predictors of Decision Regret among Caregivers of Older Canadians Receiving Home Care: A Cross-Sectional Online Survey. MDM Policy Pract 2022; 7:23814683221116304. [PMID: 35983319 PMCID: PMC9380233 DOI: 10.1177/23814683221116304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 06/13/2022] [Indexed: 11/21/2022] Open
Abstract
Background. In Canada, caregivers of older adults receiving home
care face difficult decisions that may lead to decision regret. We assessed
difficult decisions and decision regret among caregivers of older adults
receiving home care services and factors associated with decision regret.
Methods. From March 13 to 30, 2020, at the outbreak of the
COVID-19 pandemic, we conducted an online survey with caregivers of older adults
receiving home care in the 10 Canadian provinces. We distributed a
self-administered questionnaire through Canada’s largest and most representative
private online panel. We identified types of difficult health-related decisions
faced in the past year and their frequency and evaluated decision regret using
the Decision Regret Scale (DRS), scored from 0 to 100. We performed descriptive
statistics as well as bivariable and multivariable linear regression to identify
factors predicting decision regret. Results. Among 932
participants, the mean age was 42.2 y (SD = 15.6 y), and 58.4% were male. The
most frequently reported difficult decisions were regarding housing and safety
(75.1%). The mean DRS score was 28.8/100 (SD = 8.6). Factors associated with
less decision regret included higher caregiver age, involvement of other family
members in the decision-making process, wanting to receive information about the
options, and considering organizations interested in the decision topic and
health care professionals as trustworthy sources of information (all
P < 0.001). Factors associated with more decision regret
included mismatch between the caregiver’s preferred option and the decision
made, the involvement of spouses in the decision-making process, higher
decisional conflict, and higher burden of care (all P <
0.001). Discussion. Decisions about housing and safety were the
difficult decisions most frequently encountered by caregivers of older adults in
this survey. Our results will inform future decision support interventions.
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Affiliation(s)
- Tania Lognon
- VITAM – Centre de recherche en santé durable, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
| | - Amédé Gogovor
- VITAM – Centre de recherche en santé durable, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Quebec, QC, Canada
| | - Karine V. Plourde
- VITAM – Centre de recherche en santé durable, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
| | - Paul Holyoke
- SE Research Centre, SE Health, Markham, ON, Canada
| | - Claudia Lai
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | | | | | - Carolyn Canfield
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Caregiver Partner, Canada
| | | | - Dawn Stacey
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Patient Decision Aids Research Group, Clinical Epidemiology Program, Ottawa, ON, Canada
| | - Louis-Paul Rivest
- Tier 1 Canada Research Chair in Statistical Sampling and Data Analysis, Université Laval, Quebec, QC, Canada
- Faculty of Sciences and Engineering, Department of Mathematics and Statistics, Université Laval, Quebec, QC, Canada
| | - France Légaré
- VITAM – Centre de recherche en santé durable, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Research Center CHU de Québec, Université Laval, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada
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10
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Légaré F, Stacey D, Forest PG, Archambault P, Boland L, Coutu MF, Giguère AMC, LeBlanc A, Lewis KB, Witteman HO. Shared decision-making in Canada: Update on integration of evidence in health decisions and patient-centred care government mandates. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 171:22-29. [PMID: 35606312 DOI: 10.1016/j.zefq.2022.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
In Canada, government mandates for patient-centred care (PCC) vary across the 10 provinces and three territories. Although basic medical and hospital services are provided for all, health care options for patients also depend on having private insurance. Thus, the current design of the Canadian healthcare system has several implications for PCC and shared decision-making (SDM). Since 2007, this is our fourth update on SDM in Canada. The aim of this paper is to provide an update on the current state of SDM and patient and public involvement in Canada. Overall, we still observed the difficulty of implementing any sort of national strategy partly because of the decentralized nature of the healthcare system. Second, national professional education programs are complicated by licensure and scope of practice variations across jurisdictions. Third, there are variations in the availability of different options covered by universal healthcare. Canada has experienced some favorable development as PCC is now explicitly articulated in the policies of most provinces and territories and there are increased efforts to give patients more access to their electronic health records. However, patient and public engagement (PPE) reform in health programs and governance remains an exception, and continuing centralization of governance structures may reduce their responsiveness to patient priorities. In a 2018 survey, 47.2% of respondents reported that they were not told by their health professional that they had a choice about treatment. Nonetheless, decision aids and decision coaching are increasingly available for health-related decisions and the Ottawa Hospital Research Institute's decision aid inventory has ensured continued leadership in this area. Diverse jurisdictions are starting to embed decision aids into care pathways, with some decision aids being included in clinical practice guidelines. The COVID-19 pandemic may have had a negative impact on SDM by removing decision choices due to emergency public health mandates, but stimulated new research and decision aids. Canada continues to assign health research funding to SDM and PCC, and a program dedicated to patient-oriented research is central to this effort. Guides and frameworks are increasingly available for planning and evaluating PPE. Finally, various initiatives are attempting to involve and empower Indigenous peoples through PPE and SDM.
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Affiliation(s)
- France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Canada.
| | - Dawn Stacey
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Patrick Archambault
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Canada; Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Lévis, Canada; Department of Anesthesiology and Intensive Care Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
| | - Laura Boland
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
| | - Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation affiliated with Hôpital Charles-Lemoyne Research Center, Rehabilitation School, Longueuil Campus - Université de Sherbrooke, Longueuil, Canada
| | - Anik M C Giguère
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
| | - Annie LeBlanc
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
| | - Krystina B Lewis
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; University of Ottawa Heart Institute, Ottawa, Canada
| | - Holly O Witteman
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Canada; Ottawa Hospital Research Institute, Ottawa, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
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11
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Improving the Process of Shared Decision-Making by Integrating Online Structured Information and Self-Assessment Tools. J Pers Med 2022; 12:jpm12020256. [PMID: 35207744 PMCID: PMC8879344 DOI: 10.3390/jpm12020256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 12/10/2022] Open
Abstract
The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process with topics and content developed through a participatory design approach. We analyzed the triggered and completed SDM cases with responses from participants at a medical center in Taiwan. Data were retrieved from the Research Electronic Data Capture (REDCap) database of the hospital for analysis. Each team developed web-based patient decision aids (PDA) with empirical evidence in a multi-digitized manner, allowing patients to scan QR codes on a leaflet using their mobile phones and then read the PDA content online. From July 2019 to December 2020, 48 web-based SDM topics were implemented in the 24 clinical departments of this hospital. The results showed that using the REDCap system improved SDM efficiency and quality. Implementing an online SDM process integrated with face-to-face communication enhanced the practice and effectiveness of SDM, possibly through the flexibility of accessing information, self-assessment, and feedback evaluation.
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12
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Davies N, Sampson EL, West E, DeSouza T, Manthorpe J, Moore K, Walters K, Dening KH, Ward J, Rait G. A decision aid to support family carers of people living with dementia towards the end-of-life: Coproduction process, outcome and reflections. Health Expect 2021; 24:1677-1691. [PMID: 34288291 PMCID: PMC8483186 DOI: 10.1111/hex.13307] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/17/2021] [Accepted: 06/06/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Family carers of people living with dementia often need support with making decisions about care. Many find end-of-life care decisions particularly difficult. The aim of this article is to present an evidence- and theoretical-based process for developing a decision aid to support family carers of people with dementia towards the end-of-life. METHODS Following a systematic process, we developed a decision aid using coproduction methods and matrices to synthesize data from a systematic review and qualitative interviews with people living with dementia and family carers. Data were presented to coproduction workshops of people living with dementia, family carers, practitioners and professionals. Development was guided by the Ottawa Decision Support Framework and a modified Interprofessional Shared Decision-Making model. RESULTS The decision aid covers four decision areas: (1) changes in care; (2) eating and drinking difficulties; (3) everyday well-being; and (4) healthcare, tests and medication. We present an interactive decision aid, using a variety of approaches including written text, Frequently Asked Questions, top tips and illustrative quotes from people living with dementia and family carers. CONCLUSION This is the first decision aid that focusses on multiple decisions towards the end-of-life in dementia care. The process offers a template for others to develop decision aids or similar interventions, and how to include people living with dementia in coproduction. PATIENT OR PUBLIC CONTRIBUTION Family carers provided feedback on data collection, data analysis and the decision aid, and one is a coauthor. People living with dementia and family carers were integral to the coproduction workshops.
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Affiliation(s)
- Nathan Davies
- Department of Primary Care and Population Health, Royal Free CampusUniversity College LondonLondonUK
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
| | - Elizabeth L. Sampson
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
- Barnet, Enfield and Haringey Mental Health Trust, Liaison Psychiatry TeamNorth Middlesex University HospitalLondonUK
| | - Emily West
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
| | - Tanisha DeSouza
- Department of Primary Care and Population Health, Royal Free CampusUniversity College LondonLondonUK
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute at King'sKing's College LondonLondonUK
- NIHR Applied Research Collaborative (ARC) South LondonKing's College LondonLondonUK
| | - Kirsten Moore
- Marie Curie Palliative Care Research DepartmentUniversity College LondonLondonUK
- National Ageing Research InstituteParkvilleVictoriaAustralia
| | - Kate Walters
- Department of Primary Care and Population Health, Royal Free CampusUniversity College LondonLondonUK
| | | | - Jane Ward
- Family Carer, Member of Experts by Experience Panel
| | - Greta Rait
- Department of Primary Care and Population Health, Royal Free CampusUniversity College LondonLondonUK
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13
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Witteman HO, Maki KG, Vaisson G, Finderup J, Lewis KB, Dahl Steffensen K, Beaudoin C, Comeau S, Volk RJ. Systematic Development of Patient Decision Aids: An Update from the IPDAS Collaboration. Med Decis Making 2021; 41:736-754. [PMID: 34148384 DOI: 10.1177/0272989x211014163] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The 2013 update of the evidence informing the quality dimensions behind the International Patient Decision Aid Standards (IPDAS) offered a model process for developers of patient decision aids. OBJECTIVE To summarize and update the evidence used to inform the systematic development of patient decision aids from the IPDAS Collaboration. METHODS To provide further details about design and development methods, we summarized findings from a subgroup (n = 283 patient decision aid projects) in a recent systematic review of user involvement by Vaisson et al. Using a new measure of user-centeredness (UCD-11), we then rated the degree of user-centeredness reported in 66 articles describing patient decision aid development and citing the 2013 IPDAS update on systematic development. We contacted the 66 articles' authors to request their self-reports of UCD-11 items. RESULTS The 283 development processes varied substantially from minimal iteration cycles to more complex processes, with multiple iterations, needs assessments, and extensive involvement of end users. We summarized minimal, medium, and maximal processes from the data. Authors of 54 of 66 articles (82%) provided self-reported UCD-11 ratings. Self-reported scores were significantly higher than reviewer ratings (reviewers: mean [SD] = 6.45 [3.10]; authors: mean [SD] = 9.62 [1.16], P < 0.001). CONCLUSIONS Decision aid developers have embraced principles of user-centered design in the development of patient decision aids while also underreporting aspects of user involvement in publications about their tools. Templates may reduce the need for extensive development, and new approaches for rapid development of aids have been proposed when a more detailed approach is not feasible. We provide empirically derived benchmark processes and a reporting checklist to support developers in more fully describing their development processes.[Box: see text].
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Affiliation(s)
- Holly O Witteman
- Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Quebec City, Canada.,VITAM Research Centre, Quebec City, Canada.,CHU de Québec Research Centre, Quebec City, Canada
| | - Kristin G Maki
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gratianne Vaisson
- Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Quebec City, Québec, Canada
| | - Jeanette Finderup
- Research Centre for Patient Involvement & Department of Renal Medicine, Aarhus University & Aarhus University Hospital, Aarhus, Denmark
| | - Krystina B Lewis
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Karina Dahl Steffensen
- Center for Shared Decision Making/Department of Oncology, Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark.,Institute of Regional Health Research, Faculty of Health Sciences, Vejle, Denmark
| | - Caroline Beaudoin
- Department of Family and Emergency Medicine, Laval University, Quebec, Canada
| | - Sandrine Comeau
- Department of Family and Emergency Medicine, Laval University, Quebec, Canada
| | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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14
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Köther AK, Siebenhaar KU, Alpers GW. Shared Decision Making during the COVID-19 Pandemic. Med Decis Making 2021; 41:430-438. [PMID: 33783266 DOI: 10.1177/0272989x211004147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals' attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic. METHODS We conducted an online survey with a large convenience sample (N = 1061). Our main measures of interest were participants' generic and COVID-19-related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants' health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance. RESULTS In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19-related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19-related participation preferences predicted lower triage acceptance. CONCLUSION Our findings demonstrate potential health care recipients' attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.
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Affiliation(s)
- Anja K Köther
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Baden-Wurttemberg, Germany
| | - Katharina U Siebenhaar
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Baden-Wurttemberg, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Baden-Wurttemberg, Germany
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