A decision aid regarding treatment options for patients with an asymptomatic abdominal aortic aneurysm: a randomised clinical trial
| Autor: | Anouk M. Knops, N.A. Koedam, Mark J.W. Koelemay, A.J. de Nie, Dink A. Legemate, Anco C. Vahl, Astrid Goossens, P.J. Van den Akker, Dirk T. Ubbink, J.C.J.M. de Haes, M.C.M. Willems, Ron Balm, Patrick M.M. Bossuyt |
|---|---|
| Přispěvatelé: | Patient Care Support, Nursing, Surgery, Amsterdam Cardiovascular Sciences, Amsterdam Public Health, Medical Psychology, Epidemiology and Data Science, 10 Public Health & Methodologie, 02 Surgical specialisms |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Decisional conflict Decision Support Techniques Patient satisfaction Aneurysm Patient Education as Topic Surveys and Questionnaires medicine Humans Patient participation Watchful Waiting Elective surgery Aged Medicine(all) business.industry medicine.disease Abdominal aortic aneurysm Surgery Clinical trial CD-ROM Elective Surgical Procedures Patient Satisfaction Physical therapy Quality of Life Anxiety Female medicine.symptom Patient Participation Cardiology and Cardiovascular Medicine business Watchful waiting Aortic Aneurysm Abdominal |
| Zdroj: | European journal of vascular and endovascular surgery, 48(3), 276-283. W.B. Saunders Ltd |
| ISSN: | 1078-5884 |
| Popis: | Objective Abdominal aortic aneurysm patients tend to be informed inconsistently and incompletely about their disorder and the treatment options open to them. The objective of this trial was to evaluate whether these patients are better informed and experience less decisional conflict regarding their treatment options after viewing a decision aid. Design A six-centre, randomised clinical trial comparing a decision aid plus regular information versus regular information from the surgeon. Methods Included patients had recently been diagnosed with an asymptomatic abdominal aortic aneurysm at least 4 cm in diameter. The decision aid consisted of a one-time viewing of an interactive CD-ROM elaborating on elective surgery versus watchful waiting. Generally, the decision aid advised patients with aneurysms less than 5.5 cm to agree to watchful waiting, for larger aneurysms the decision aid provided insight into the balance of benefit and harm of surgical and conservative approaches, taking into account age, co-morbidity and size of the aneurysm. The primary outcome was patient decisional conflict measured at 1 month follow-up (Decisional Conflict Scale). Secondary outcomes were patient knowledge, anxiety and satisfaction. Results In 178 aneurysm patients, decisional conflict scores did not differ significantly between the decision aid and the regular information groups (22 vs. 24 on the 0–100 Decisional Conflict Scale; p = .33). Patients in the decision aid group had significantly better knowledge (10.0 vs. 9.4 out of 13 points; p = .04), whereas anxiety levels (4.4 and 5.0 on a 0–21 scale; p = .73) and satisfaction scores (74 and 73 on a 0–100 scale; p = .81) were similar in both groups. Conclusion In addition to regular patient-surgeon communication, a decision aid helps to share treatment decisions with abdominal aortic aneurysm patients by increasing their knowledge about the disorder and available treatment options without raising anxiety levels; however, it does not reduce decisional conflict, nor does it improve satisfaction. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect