Aims and objectives: No validated version of the 9-item Shared Decision Making Questionnaire (SDM-Q-9) in Danish is available. The aim of the study was to translate, culturally adapt and psychometrically test a Danish version of the SDM-Q-9 in 2 patient groups: elderly patients from outpatient gynecology clinics and a group of younger patients from an outpatient sports clinic.Method: The SDM-Q-9, patient version, was translated into Danish through a standardized forward-backward translation performed by 4 independent translators, followed by cognitive interviewing of 11 outpatients from the 2 patient groups. The process was adjusted by an expert panel. The psychometric testing was performed at 5 Danish hospital departments. Reliability (internal consistency) was estimated by Cronbach’s alpha. Construct validity was determined by confirmatory and explanatory factor analysis.Results: A total of 268 patients (218 gynecological and 50 knee patients) were included. The scale had high reliability (Cronbach’s alpha of 0.94). A high ceiling effect was found (44% with the highest rating). None of the tested models in the confirmatory analysis had a good fit. The explanatory factor analysis for the whole sample yielded a unidimensional factor, which explained 91% of variances with high factor loadings of more than 0.7.Conclusion: The Danish version of the SDM-Q-9 is a well-accepted, reliable and - despite the challenges of a high ceiling effect - valid instrument in the tested populations. Further psychometrical testing in other populations is necessary as well as research with other convergent instruments to demonstrate consistency over time and between patient groups.
The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest, pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC and lifting 2 and 5 kg. Lifting in the walking position created a slightly higher VP compared to other lifting techniques, which did not differ. The VP did not increase when lifting 5 kg compared to 2 kg. Mean VP during coughing and Valsalva were significantly lower 1-5 days after the operation. VP was not related to the type of vaginal repair. The results imply that post-operative counselling should concentrate more on treating chronic cough and constipation than restrictions of moderate physical activities.
Background Female patients with pelvic organ prolapse and clinicians need to take decisions regarding treatment that are often unpredictable in relation to how they impact the future everyday lives of the patients. This study formed the developmental phase of a larger study to develop and test an online tool to support shared decision-making. Methods Patients, health care professionals and other stakeholders participated in the development and evaluation process of this tool. The collected data was generated from observational studies, exploratory interviews with prompt cards and workshops with end users from four Danish gynecology outpatient clinics. Results Content analysis led to important themes. For the patients three themes emerged: 1) how the impact of symptoms on everyday life affected the need for relief, 2) their bodily perception and sex life and 3) their worries about the future. For clinicians the different symptoms and their severity was a main theme. Conclusions This article provides an overall description and discussion of the development methodology. It demonstrates how user involvement informed the prototyping process and how patients’ preferences were included in the final prototype. Whether the tool actually increases SDM, remains to be tested in a pilot feasibility study.
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