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Decision aid use during post-biopsy consultations for localized prostate cancer
- Source :
- Health expectations : an international journal of public participation in health care and health policy, vol 21, iss 1, Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Author(s): Holmes-Rovner, Margaret; Srikanth, Akshay; Henry, Stephen G; Langford, Aisha; Rovner, David R; Fagerlin, Angela | Abstract: BackgroundDecision Aids (DAs) effectively translate medical evidence for patients but are not routinely used in clinical practice. Little is known about how DAs are used during patient-clinician encounters.ObjectiveTo characterize the content and communicative function of high-quality DAs during diagnostic clinic visits for prostate cancer.Participants252 men newly diagnosed with localized prostate cancer who had received a DA, 45 treating physicians at 4 US Veterans Administration urology clinics.MethodsQualitative analysis of transcribed audio recordings was used to inductively develop categories capturing content and function of all direct references to DAs (booklet talk). The presence or absence of any booklet talk per transcript was also calculated.ResultsBooklet talk occurred in 55% of transcripts. Content focused on surgical procedures (36%); treatment choice (22%); and clarifying risk classification (17%). The most common function of booklet talk was patient corroboration of physicians' explanations (42%), followed by either physician or patient acknowledgement that the patient had the booklet. Codes reflected the absence of DA use for shared decision-making. In regression analysis, predictors of booklet talk were fewer years of patient education (Pn=n.027) and more time in the encounter (Pn=n.027). Patient race, DA type, time reading the DA, physician informing quality and physician age did not predict booklet talk.ConclusionsResults show that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.
- Subjects :
- Male
Aging
Biopsy
Prostate cancer
0302 clinical medicine
Psychology
030212 general & internal medicine
Referral and Consultation
Qualitative Research
Cancer
patient‐centred communication
medicine.diagnostic_test
Prostate Cancer
030503 health policy & services
Middle Aged
prostate cancer
3. Good health
Original Research Paper
United States Department of Veterans Affairs
Medical evidence
Public Health and Health Services
Urologic Surgical Procedures
Public Health
0305 other medical science
Adult
Urologic Diseases
medicine.medical_specialty
Urologic Surgical Procedures, Male
Decision Making
Nursing
Decision Support Techniques
03 medical and health sciences
shared decision‐making
Patient Education as Topic
Acquired immunodeficiency syndrome (AIDS)
Clinical Research
medicine
Humans
veterans
Gynecology
Physician-Patient Relations
business.industry
shared decision-making
Public Health, Environmental and Occupational Health
Prostatic Neoplasms
Surgical procedures
medicine.disease
United States
decision aids
patient-centred communication
Family medicine
Risk classification
business
Original Research Papers
Patient education
Qualitative research
Subjects
Details
- ISSN :
- 13696513
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Health Expectations
- Accession number :
- edsair.doi.dedup.....6bbcbebfdb1ce46ea4133082ac85accf