Effectiveness of Decision Aids A Review of the Evidence
University of North Carolina, Chapel Hill, NC, USA.Medical Care Research and Review (Impact Factor: 2.62). 12/2008; 65(6 Suppl):79S-116S. DOI: 10.1177/1077558708324234
Increased interest in health care consumerism has created an environment conducive to growth in the use of decision aids (DAs) to support patient decision making. The authors review the research literature published within the past 5 years that assesses the effects of DAs in the areas of screening and treatment. Multiple measures are used to evaluate the effectiveness of DAs, with mixed evidence of impacts. To date, most evidence from screening studies suggests that DAs are effective in increasing knowledge and are acceptable to patients, but patient uptake of screening has been mixed. Among treatment studies, there is some, but limited, evidence showing impact of DAs on immediate and long-term decisional conflict, patient satisfaction, and quality of life. Few studies provide assessment of impact on health outcomes, quality of care, utilization, or costs, all areas likely to be of growing interest to private purchasers, insurers, and public programs.
- Mathematical Systems Theory 06/1969; 3(2):151-155. DOI:10.1007/BF01746522
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ABSTRACT: Information has been identified as a critical factor in improving health outcomes, self-management, and patient satisfaction. New ways of understanding how patients build knowledge for medical decision-making and self-care are needed. This paper presents a framework for potential contributions that information and knowledge management can bring to primary health care. A literature review was conducted to reveal concepts about information use and theories of knowledge management that are applicable to the study of patient education and may aid researchers in understanding information processes affecting individuals and their health. The search revealed information science and knowledge management theories had not previously been used to understand patient learning. This represents the first application of information behavior theories to the study of patient education. The theories discussed were used to create a model for examining and identifying enablers, critical processes, and consequences of patient learning in order to enhance the development of knowledge critical to informed medical decision-making and self-care. Patient education occurs beyond the boundaries of the healthcare system, so practitioners may wish to broaden their connections with diverse organizations that can enhance medical and health-related knowledge.Knowledge Work. New Brunswick, NJ. The Knowledge Institute. Rutgers University. 139-158., Edited by A.W. Hastings, c. mcinerney, 01/2010: chapter A New View of Patient Education: How Information and Knowledge Management Can Contribute to Patient-Centered Health Care: pages 139-158; The Knowledge Institute. Rutgers University.
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ABSTRACT: OBJECTIVE: To assess the relative impact of cognitive and emotional aspects of shared decision making (SDM) on patient outcomes. METHODS: Cognitive and emotional aspects of SDM in consultations between 20 oncologists and 55 early breast cancer patients were coded using the Observing Patient Involvement (OPTION) scale and the Response to Emotional Cues and Concerns (RECC) coding system, plus blocking and facilitating behaviour scales. Patient outcomes including anxiety, decisional conflict, and satisfaction with: (i) the decision, (ii) the consultation, and (iii) doctor SDM skills, were assessed. Relationships between cognitive and emotional aspects of SDM, and patient outcomes were examined using hierarchical regression. RESULTS: The OPTION score predicted satisfaction with doctor SDM skills 2 weeks post-consultation (p=.010), and with the treatment decision 4 months post-consultation (p=.004). Emotional blocking predicted decisional conflict (p=.039), while the number of emotional cues emitted (p=.003), and the degree of empathy provided (p=.011), predicted post-consultation anxiety. CONCLUSION: Cognitive and emotional aspects of SDM in oncology consultations have different effects on various patient outcomes. PRACTICE IMPLICATIONS: It is important that doctors focus on both sharing decisions and managing emotions in consultations. Communication skills training addressing both these areas may be an effective way to improve diverse patient outcomes.Patient Education and Counseling 04/2010; 82(2-2):233-9. DOI:10.1016/j.pec.2010.04.001 · 2.20 Impact Factor
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