Impact of the Ottawa Decision Support Framework on the Agreement and the Difference between Patients' and Physicians' Decisional Conflict

Abstract

After implementing the ODSF, there was less dissimilarity between patients' and physicians' DSC than expected by chance than before. Implementing the ODSF was also found to be associated with the difference between patients' and physicians' DSC. The physician level explained a significant amount of the variance in this outcome, thus emphasizing the importance of an intervention at this level.

The decisional conflict scale: moving from the individual to the dyad level

“…We replicated the results from this exploratory work in a study that assessed the impact of implementing SDM on the agreements and the differences between health professionals' and patients' decisional conflict scores [32]. Dyadic scales should always be constructed using items of the same nature and the same item structure, however.…”

“…Therefore, in this study the DCS used by health professionals (Cronbach's alpha = 0.90) comprised the same 16 items as the DCS used by patients (Cronbach's alpha = 0.85), whereas the PDPAI, used in earlier studies, only included eight of the items from the original DCS. In total, 120 health professionals and 903 patients were enrolled in our before-and-after study [32]. Patients' and health professionals' mean DCS scores were 1.36 (standard deviation [SD] = 0.38) and 1.72 (SD = 0.47) respectively.…”

Primary health care professionals’ views on barriers and facilitators to the implementation of the Ottawa Decision Support Framework in practice

“…However, in contrast with the first recruitment period, at the beginning of each of their clinical sessions, they were given a paper-based reminder of the ODSF. Results pertaining to the data collected after the clinical encounters can be found elsewhere [22]. At the end of the trial, physicians completed an exit questionnaire.…”

La prise de décision entourant l’alimentation par sonde de gastrostomie chez les enfants ayant une atteinte neurologique : engager un dialogue efficace avec les familles

“…Ce conflit est plus susceptible de se produire lorsque le choix s'associe à des risques, à une incertitude quant aux résultats, à des sentiments de deuil ou de regret ou à une inadéquation avec les valeurs personnelles (8). Selon une analyse systématique de l' ASGS, les parents d'enfants ayant une atteinte neurologique vivent souvent un conflit décisionnel au moment d'envisager cette intervention (6).…”