Clinician feedback using a shared decision-making tool for the evaluation of patients with thyroid nodules-an observational study.

Autor: Singh Ospina N; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA. Naykky.SinghOspina@medicine.ufl.edu., Patel Chavez C; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA., Godinez Leiva E; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA., Bagautdinova D; College of Journalism and Communications, University of Florida, Gainesville, FL, USA., Hidalgo J; Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA., Hartasanchez S; Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA., Algarin Perneth S; Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA., Barb D; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA., Danan D; Department of Otolaryngology, University of Florida, Gainesville, FL, USA., Dziegielewski P; Department of Otolaryngology, University of Florida, Gainesville, FL, USA., Hughley B; Department of Otolaryngology, University of Florida, Gainesville, FL, USA., Srihari A; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA., Subbarayan S; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA., Castro MR; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Dean D; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Morris J; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Ryder M; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Stan MN; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Hargraves I; Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA., Bylund CL; Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA., Treise D; College of Journalism and Communications, University of Florida, Gainesville, FL, USA., Montori VM; Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA.; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Brito JP; Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA.; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2024 Feb; Vol. 83 (2), pp. 449-458. Date of Electronic Publication: 2023 Sep 11.
DOI: 10.1007/s12020-023-03519-z
Abstrakt: Background: We pilot-tested an encounter conversation aid to support shared decision making (SDM) between patients with thyroid nodules and their clinicians.
Objective: Characterize the clinician feedback after providing care to patients with thyroid nodules using a tool to promote SDM conversations during the clinical encounter, and evaluate how clinicians used the tool during the visit.
Methods: Mixed method study in two academic centers in the U.S., including adult patients presenting for evaluation of thyroid nodules and their clinicians. We thematically analyzed interviews with clinicians after they used the SDM tool in at least three visits to characterize their feedback. Additionally, investigators evaluated visits recordings to determine the extent to which clinicians engaged patients in the decision-making process (OPTION score, scale 0 to 100, higher levels indicating higher involvement), the tool's components used (fidelity), and encounter duration. Using a post-visit survey, we evaluated the extent to which clinicians felt the tool was easy to use, helpful, and supportive of the patient-clinician collaboration.
Results: Thirteen clinicians participated in the study and used the SDM tool in the care of 53 patients. Clinicians thought the tool was well-organized and beneficial to patients and clinicians. Clinicians noticed a change in their routine with the use of the conversation aid and suggested it needed to be more flexible to better support varying conversations. The median OPTION score was 34, the fidelity of use 75%, and the median visit duration 17 min. In most encounters, clinicians agreed or strongly agreed the tool was easy to use (86%), helpful (65%), and supported collaboration (62%).
Conclusion: Clinicians were able to use a SDM tool in the care of patients with thyroid nodules. Although they wished it were more flexible, they found on the whole that its use in the clinical encounter was beneficial to patients and clinicians.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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