Objective
To participate in shared decision making (SDM), patients need to understand their options and develop trust in their own decision‐making abilities. Two experiments investigated the potential of decision aids (DAs) in preparing patients for SDM by raising awareness of preference‐sensitivity (Study 1) and showing possible personal motives for decision making (Study 2) in addition to providing information about the treatment options.
Methods
Participants (Study 1: N = 117; Study 2: N = 217) were put into two scenarios (Study 1: cruciate ligament rupture; Study 2: contraception), watched a consultation video and were randomized into one of three groups where they received additional information in the form of (a) narrative patient testimonials; (b) non‐narrative decision strategies; and (c) an unrelated text (control group).
Results
Participants who viewed the patient testimonials or decision strategies felt better prepared for a decision (Study 1: P < .001, ηP2 = 0.43; Study 2: P < .001, ηP2 = 0.57) and evaluated the decision‐making process more positively (Study 2: P < .001, ηP2 = 0.13) than participants in the control condition. Decision certainty (Study 1: P < .001, ηP2 = 0.05) and satisfaction (Study 1: P < .001, ηP2 = 0.11; Study 2: P = .003, d = 0.29) were higher across all conditions after watching the consultation video, and certainty and satisfaction were lower in the control condition (Study 2: P < .001, ηP2 = 0.05).
Discussion
Decision aids that explain preference‐sensitivity and personal motives can be beneficial for improving people's feelings of being prepared and their perception of the decision‐making process. To reach decision certainty and satisfaction, being well informed of one's options is particularly relevant. We discuss the implications of our findings for future research and the design of DAs.
Objective: In order to participate in shared decision-making (SDM), patients need to understand their options and develop trust in their decision-making abilities. Two experiments investigated the potential of decision aids in preparing patients for SDM by raising awareness of preference-sensitivity (Study 1) or showing possible personal motives for decision-making (Study 2).Methods: Participants (Study 1: N = 117; Study 2: N = 217) were put in fictional scenarios (Study 1: cruciate ligament rupture; Study 2: contraception), watched a consultation video and were randomized into one of three interventions: 1) Narrative decision aid (patient testimonial); 2) non-narrative decision aid (fact list); 3) control group (unrelated text). Results: Participants who viewed a decision aid felt better prepared for a decision (Study 1: p < .001, η2p = 0.43; Study 2: p < .001, η2p = 0.57) and evaluated the decision-making process more positively (Study 2: p < .001, η2p = 0.13) than participants in the control condition. In Study 1, decision certainty (p = .002, d = 0.46) and satisfaction (p < .001, d = 0.65) were higher across all conditions after watching the consultation video. In Study 2, decision certainty increased for participants in the narrative and decreased in the non-narrative condition (p = .038, d = 0.36). Discussion: Decision aids can be helpful for improving patients’ feelings of being prepared and their perception of the decision-making process, independently of their format. Regarding decision certainty and satisfaction, good consultations seem to be more important than the application of decision aids.
Zusammenfassung. Theoretischer Hintergrund: Kindesmisshandlung, -missbrauch und Vernachlässigung stellen ein gesamtgesellschaftliches Entwicklungsrisiko für Kinder in Deutschland dar. Zweithäufigster Kontext des Geschehens nach dem familiären Umfeld sind Institutionen. Fragestellung: Der vorliegende Artikel gibt eine Übersicht zu Häufigkeiten von Übergriffen durch Angehörige der Heil- und Pflegeberufe mit Schwerpunkt auf dem kinder- und jugendpsychiatrischen/-psychotherapeutischen Bereich. Methode: Mittels Literaturrecherche wird der Forschungsstand zum Thema dargestellt. Ergebnisse: Neben Auswertungen zu Zwangsmaßnahmen, welche von Betroffenen häufig als viktimisierend erlebt werden, existieren für Deutschland zwei repräsentative retrospektive Befragungen zum medizinischen Bereich. Hier ergaben sich Prävalenzen zwischen einem Fünftel und einem Drittel der Befragten, die mindestens eine Form von Gewalt oder Vernachlässigung bejahten. Diskussion und Schlussfolgerung: Neben alarmierenden Zahlen zeigt sich der große Bedarf an weiterer Forschung zum Thema.
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