Dawn Stacey

• RN, PhD
• Distinguished Professor at University of Ottawa

Background Patient decision aids (PtDAs) are effective interventions to help people participate in health care decisions. Although there are quality standards, PtDAs are complex interventions with variability in their attributes. Purpose To determine and compare the effects of PtDA attributes (e.g., content elements, delivery timing, development)...

Background Shared decision-making (SDM) is a collaborative patient-centred process for arriving at informed healthcare decisions. Decision coaching can help support SDM when combined with patient decision aids. As part of a meta-curriculum “Ready for SDM” for training different healthcare professionals in SDM, we developed and pilot-tested a new mo...

Symptoms of the Post-COVID-19 Condition are often non-specific making it a challenge to distinguish them from symptoms due to other medical conditions. In this study, we compare the proportion of emergency department patients who developed symptoms consistent with the World Health Organization’s Post-COVID-19 Condition clinical case definition betw...

Introduction Total joint arthroplasty (TJA) for osteoarthritis is one of several treatment options with benefits and harms that patients value differently. However, the process for determining TJA appropriateness does not sufficiently acknowledge patient perspectives. The aim of this paper is to propose an evidence‐informed patient‐centred conceptu...

Background Use of extended pharmacologic thromboprophylaxis after major abdominopelvic cancer surgery should depend on best-available scientific evidence and patients’ informed preferences. We developed a risk-stratified patient decision aid to facilitate shared decision-making and sought to evaluate its effect on decision-making quality regarding...

Introduction To update standards for quality and effectiveness of patient decision aids (PtDAs), the International Patient Decision Aid Standards (IPDAS) Collaboration reviewed the evidence supporting the current criteria. Evidence Update 2.0 reviews representing 11 core IPDAS domains were published in 2021. Here we report findings from the Network...

Introduction Since its first publication, the Cochrane Review of Patient Decision Aids team has been committed to collaborating with knowledge users (e.g. patients/health consumers, caregivers) as research team members. Little is known about knowledge users’ involvement in the conduct of systematic reviews. During its most recent update, we evaluat...

Introduction Little is known about the factors influencing people making decisions about the COVID-19 booster vaccine given the evolution of the COVID-19 virus, the updated vaccines, and easing of public health restrictionsOur study aims to: (1) identify factors influencing COVID-19 booster vaccine decisions; and (2) determine the decisional needs...

Introduction There are few opportunities in undergraduate nursing curriculum for students to acquire knowledge and skills in shared decision-making (SDM). Through a theory-based learning assignment, we aimed to explore how undergraduate nursing students understand and participate in SDM in their clinical placements. Methods Descriptive analysis of...

Introduction Since the first COVID-19 vaccine was approved in December 2020, Canadians faced the decision of whether or not to get the COVID-19 vaccination. We sought to identify Canadians’ decisional needs about COVID-19 vaccination. Methods We conducted two online surveys of adult Canadians (aged≥18) to explore decisions and decisional needs dur...

Introduction Patients with chronic kidney disease (CKD) face the difficult decision about choosing type of dialysis. The purpose of this case study was to explore the use of a decision support intervention provided by a nurse recently trained in decision coaching. Methods A case study was conducted guided by the Ottawa Decision Support Framework....

Introduction Symptoms can quickly become life-threatening for people receiving cancer treatments; thus, high quality symptom assessment and decision triage tools are critical for keeping patients safe. We co- produced the pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) practice guides, a set of evidence-informed symptom triage dec...

Introduction Oral health is critical for general health and quality of life [1–3]. Although there is emphasis on person-centred care in dental healthcare [4], little is known about how patient involvement in decision making is conceptualized in this context. Objective To identify and conduct a theory analysis of theories, conceptual models, or the...

Introduction The Norwegian healthcare system is committed to SDM and training healthcare professionals is crucial for successful implementation. Evaluated SDM training modules, including Germany’s doktormitSDM and trainings from the Ottawa Hospital Research Institute are available. In response to an identified lack of SDM training in Norway, we aim...

Background Although women face a wide range of contraceptive options, globally, young women are at risk of unintended pregnancies. Our umbrella review aimed to determine the decisional needs of nulligravida women aged 11 to 30 considering contraceptive options and identify effective interventions to support their involvement in making decisions abo...

Background Co-production is a collaborative approach to prepare, plan, conduct, and apply research with those who will use or be impacted by research (knowledge users). Our team of knowledge users and researchers sought to conduct and evaluate co-production of a systematic review on decision coaching. Methods We conducted a mixed-methods case stud...

Les lignes directrices canadiennes recommandent la prise de décision partagée aux femmes de moins de 50 ans qui envisagent de passer des examens de dépistage du cancer du sein. Les infirmières peuvent les épauler dans le processus de décision. La présente étude de cas, menée selon une approche pré-test/post-test auprès d’une seule participante, a m...

Canadian guidelines recommend shared decision making for women under 50 years old considering breast cancer screening. Nurses can support women for making these decisions. This single case pre-/post-test study measured change in decisional conflict after decision support for a woman under 50 years old considering whether or not to initiate mammogra...

UNSTRUCTURED Objective: This scoping review aims to summarize the steps for adapting patient decision aids (PDAs) based on current research and to explore related methodologies. Methods: A systematic search of the PubMed, Cochrane Library, EMBASE, CINAHL, Web of Science, CNKI, WANFANG, VIP, and SinoMed databases and grey literature was conducted up...

Background Contemporary guidelines recommend extended-duration anticoagulation among patients with a first unprovoked venous thromboembolism (VTE). Little is known about whether this recommendation aligns with patient values after a bleeding complication. Objectives To explore the experiences, values, and decisional needs of patients with unprovok...

Background After curative surgery for early-stage breast cancer, patients face a decision on whether to undergo surgery alone or to receive one or more adjuvant treatments, which may lower the risk of recurrence. Variations in survival outcomes are often marginal but there are differences in the side effects and other features of the options that p...

New treatments for ovarian cancer are available that require trade-offs between progression-free survival and quality of life. The aim of this study was to develop a decision aid for patients with homologous recombinant proficient (HRP) tumors, as the benefit–harm ratio of niraparib needs consideration. This decision aid was created with a systemat...

Background When people who can use or benefit from research findings are engaged as partners on study teams, the quality and impact of findings are better. These people can include patients/consumers and clinicians who do not identify as researchers. They are referred to as “knowledge users”. This partnered approach is called integrated knowledge t...

Background: Patient decision aids are interventions designed to support people making health decisions. At a minimum, patient decision aids make the decision explicit, provide evidence-based information about the options and associated benefits/harms, and help clarify personal values for features of options. This is an update of a Cochrane review...

Background An integral aspect of patient engagement in research, also known as patient and public involvement, is appropriately recognising patient partners for their contributions through compensation (e.g., coauthorship, honoraria). Despite known benefits to compensating patient partners, our previous work suggested compensation is rarely reporte...

Importance: Symptoms of Post-COVID-19 Condition (PCC) are non-specific and can occur due to other medical conditions, making it a challenge to distinguish PCC from other health conditions. Objective: To compare the proportion of emergency department (ED) patients who developed symptoms consistent with PCC between those who tested positive for Sever...

Background Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply impl...

Women living with cardiovascular disease face many health decisions throughout their journey. Most women want more information and greater involvement in decision-making about their health in partnership with their clinicians. Yet, facing these decisions can lead to a sense of personal uncertainty about the best course of action. The individualized...

Introduction Decision coaching is a non-directive approach to support patients to prepare for making health decisions. It is used to facilitate patients’ involvement in informed values-based decision-making and use of evidence-based health information. A recent systematic review revealed low certainty evidence for its effectiveness with and without...

Background: Medical assistance in dying (MAiD) was legalized in Canada in 2016, with legislation updated in 2021. It is unclear whether resources are available to help patients make this difficult decision; therefore, we sought to identify and quality appraise Canadian MAiD resources for supporting patients making this decision. Methods: We cond...

Background Patient engagement in research refers to collaboration between researchers and patients (i.e., individuals with lived experience including informal caregivers) in developing or conducting research. Offering non-financial (e.g., co-authorship, gift) or financial (e.g., honoraria, salary) compensation to patient partners can demonstrate ap...

Background: We know little about knowledge users’ involvement in the conduct of systematic reviews. We aimed to evaluate team members’ degree of meaningful engagement and their perceptions of having used an integrated knowledge translation (IKT) approach when updating the Cochrane Review of Patient Decision Aids. Methods: We conducted a pre-post mi...

Background There is growing evidence that context mediates the effects of implementation interventions intended to increase healthcare professionals’ use of research evidence in clinical practice. However, conceptual clarity about what comprises context is elusive. The purpose of this study was to advance conceptual clarity on context by developing...

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Heart & Stroke Foundation (Canada) Background Shared decision-making (SDM) is endorsed by multiple guidelines to help clinicians and patients achieve a high-quality treatment decision that integrates patients’ priorities, preferences and values. Patient decision...

A descriptive, cross-sectional study was conducted to determine factors influencing Canadian oncology nurses discussing cannabis use with patients experiencing chemotherapy-induced nausea (CIN). A survey invitation and three reminders were sent to 678 members of the Canadian Association of Nurses in Oncology (CANO) between February 8 and April 10,...

Une étude transversale descriptive a été réalisée pour déterminer les facteurs qui incitent les infirmières canadiennes en oncologie à suggérer la prise de cannabis à leurs patients pour soulager les nausées et vomissements induits par chimiothérapie (NVIC). Au total, 678 membres de l’Association canadienne des infirmières en oncologie (ACIO/CANO)...

Rational: The Hawker appropriateness criteria for total knee arthroplasty (TKA) are: osteoarthritis symptoms impacting quality of life, evidence of osteoarthritis, trial of conservative treatments, patient's realistic expectations, patient/surgeon agree benefits outweigh risks, and readiness for surgery. Little is known about the barriers and faci...

Total and partial knee arthroplasty versus non-surgical interventions of the knee for moderate to severe osteoarthritis (Protocol)

Objective: To identify and appraise the quality of COVID-19 patient decision aids (PtDAs). Methods: We conducted an environmental scan of online publicly available COVID-19 PtDAs. Two reviewers independently searched and extracted data. We calculated median International Patient Decision Aid Standards (IPDAS) scores and proportion scoring > 70%...

Objective: This study aimed at culturally adapting pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) Cancer-related fatigue (CRF) Practice Guide to enable its use in China. This article focuses on presenting the key cultural adaptation step: supplementing traditional Chinese medicine (TCM) nursing recommendations for CRF symptom ma...

Objectif : Évaluer l’acceptabilité du tutoriel Web en libre accès du Groupe pancanadien sur le triage des symptômes et l’aide à distance en oncologie (COSTaRS), de même que ses effets sur les connaissances des infirmières et sur leur confiance perçue à prendre en charge les symptômes du cancer. Méthodologie : Évaluation rétrospective pré-test/post...

Purpose: Evaluate the pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) open-access online tutorial. Methods: Retrospective pre-/post-test evaluation of nurses who completed the tutorial knowledge test and/or acceptability survey. The tutorial was modeled after the previously evaluated in-person workshop to prepare nurses providing...

Purpose To appraise the quality of publicly available online Canadian resources for patients with hip or knee osteoarthritis considering total joint arthroplasty (TJA) and health care professionals participating in TJA decision-making processes. Method An environmental scan. Two independent authors appraised: a) patient resources against the Inter...

Objective: To assess criteria and psychometric properties of instruments for assessing appropriateness of elective joint arthroplasty (JA) for adults with primary hip and knee osteoarthritis (OA). Methods: A systematic review guided by Cochrane methods and PRISMA guidelines. Studies were searched in five databases. Eligible articles include all...

Objective: To evaluate a newly developed blended learning programme for general practitioners (GPs) and nurses in supporting shared decision making (SDM) about palliative cancer treatment in a simulated setting. Methods: In a pre-posttest study, healthcare professionals (HCPs) participated in the blended learning (i.e. e-learning and (online) tr...

Introduction Parents of infants and young children newly diagnosed with differences of sex development (DSD) commonly face medical and psychosocial management decisions at a time when they are first learning about the condition and cannot consult their child for input. The aim of this study was to identify areas of greatest need for parental decisi...

Background: Little is known about the usefulness of decision coaching for people with kidney failure facing decisions about end-of-life care. Objectives: To investigate experiences of people with kidney failure who received decision coaching for end-of-life care decisions. Design: We conducted a prospective case study bound by time (September...

Introduction Parents and guardians of infants and young children with differences of sex development (DSD) often face numerous health and social decisions about their child’s condition. While proxy health decisions can be stressful in any circumstance, they are further exacerbated in this clinical context by significant variations in clinical prese...

Rationale: Total knee arthroplasty is a common surgical procedure but not appropriate for all patients with knee osteoarthritis. Patient decision aids (PtDAs) can promote shared decision making and enhance understanding and expectations of procedures among patients, resulting in better discussions between patients and healthcare providers about wh...

Background: Ineffective collaboration can increase adverse events in the operating theatre. When professionals work collaboratively, they are more likely to improve patient safety and outcomes. Aim: To identify interprofessional collaboration interventions involving operating theatre teams and describe their effect on facilitating communication,...

Category Sports; Trauma Introduction/Purpose Uncertainty exists regarding the best treatment for acute Achilles tendon ruptures. Simultaneous comparison of the multiple treatment options using traditional study designs is problematic; multiarm clinical trials often are logistically constrained to small sample sizes, and traditional meta-analyses a...

Background: In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years. Methods: We conduct...

Background: Extended-duration thromboprophylaxis is used to decrease risk of venous thromboembolism (VTE) after surgery but may increase the risk of bleeding. The decision to complete a course of extended-duration thromboprophylaxis can be challenging. Objective: The objective of this study was to develop an acceptable patient decision aid (PtDA...

BACKGROUND During the COVID-19 pandemic, Canadians faced difficult health-related decisions. It is important to identify their decision making needs to provide person-centred care, to improve health outcomes, and to inform future pandemic preparedness. OBJECTIVE We sought to identify their decisions and decisional needs. METHODS Our study was co-...

Background: Never before the COVID-19 pandemic, Canadians had faced making health-related decisions in a context of significant uncertainty. However, little is known about which type of decisions and the types of difficulties that they faced. Objective: We sought to identify the health-related decisions and decisional needs of Canadians. Method...

Background Decision coaching is non-directive support delivered by a trained healthcare provider to help people prepare to actively participate in making healthcare decisions. This study aimed to understand how and under what circumstances decision coaching works for people making healthcare decisions. Methods We followed the realist review method...

Interprofessional collaboration (IPC) in the OR enhances safe and effective patient care. The aim of this qualitative study was to explore perioperative nurses’ perspectives on their contributions to IPC. We conducted a secondary analysis of 19 semistructured interviews with perioperative RNs and completed inductive thematic analysis with subsequen...

Supporting people to make decisions during the covid-19 pandemic created new opportunities for shared decision making and rapid development of patient decision aids, say Michael Barry and colleagues

Background. Older adults receiving home care services often face decisions related to aging, illness, and loss of autonomy. To inform tailored shared decision making interventions, we assessed their decisional needs by asking about the most common difficult decisions, measured associated decisional conflict, and identified factors associated with i...

This Viewpoint discusses the role of the International Patient Decision Aid Standards Collaboration in emphasizing the importance of shared decision-making facilitated by trained individuals and the use of decision aids that meet minimal quality standards when counseling patients for lung cancer screening.

Purpose Patients receiving cancer treatments experience many treatment-related symptoms. Telehealth is increasingly being used to support symptom management. The overall aim was to determine the effectiveness of nurse-led telehealth symptom management interventions for patients with cancer receiving systemic or radiation therapy compared to usual c...

Introduction Parents of infants born with differences in sex development (DSD) face many difficult decisions. As part of a larger project designed to develop educational interventions to promote shared decision making, this study assessed healthcare professionals’ (HCPs) perceptions of parental decision-making needs when an infant is born with a DS...

Objectives Decision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to identify DAs developed for home and community care, verify their adherence to international DA criteria and explore the involvement of interprofessional teams in their de...

Objective: This scoping review will evaluate the current published literature on decision-making in obesity management. Introduction: Obesity is increasing in incidence worldwide. Although indications have been established for a variety of available treatment modalities, treatment selection must also factor in patient preferences, clinician expe...

Background. In Canada, caregivers of older adults receiving home care face difficult decisions that may lead to decision regret. We assessed difficult decisions and decision regret among caregivers of older adults receiving home care services and factors associated with decision regret. Methods. From March 13 to 30, 2020, at the outbreak of the COV...

Background High-grade gliomas are aggressive and life-threatening brain tumors. At the time of recurrence, the patients and their families need to decide on future treatment. None of the treatment options are curative, and tradeoffs between benefits and harms must be made. This study aimed to explore the patients’ and family members’ decisional nee...

Plain English summary Background Partnering with patients, caregivers and members of the public to co-develop and co-conduct research is becoming more accepted and prevalent. However, it is unclear how researchers recognize patient partners for their contributions to research projects. In this publication we outline a series of three studies that w...

Objective The objective of this study was to evaluate the effectiveness of an online patient decision aid with individualised potential outcomes of surgery, on the quality of decisions for knee replacement surgery in routine clinical care. Design A pragmatic Randomized Controlled Trial (RCT) in patients considering total knee replacement at a high...

Perinatal outcomes vary widely depending on individual birth settings (birth center, home, and hospital). The purpose of this case study is to explore a patient‐centered, shared decision‐making approach to achieve an informed, values‐based choice about birth settings. Engaging in a shared decision‐making approach regarding birth setting options wou...

Background: One of the toughest decisions frequently faced by frail elders is to remain at home, with or without assistance, or move into residential care. Frail elders and caregivers need support from their home care teams in making this difficult housing decision. However, home care teams are often understaffed, and busy, shared decision-making...

In Canada, government mandates for patient-centred care (PCC) vary across the 10 provinces and three territories. Although basic medical and hospital services are provided for all, health care options for patients also depend on having private insurance. Thus, the current design of the Canadian healthcare system has several implications for PCC and...

In Chile, local normative and guidelines place patient-centred care (PCC) as a desirable means and outcome for each level of health care. Thus, a definition of PCC is provided, and for the first time shared decision-making (SDM) is included as an intended practice. During the past five years the country has shown progress on the implementation of P...

Objective: Hysterectomy is a common gynaecological procedure, and therefore online information is highly valuable to patients. Our objective was to evaluate the quality, readability, and comprehensiveness of online patient information on hysterectomy. Methods: The first 25 patient-directed websites on hysterectomy, identified using 5 online sear...

Objective Ready for SDM was developed in Norway as a comprehensive modularized curriculum for health care providers (HCP). The current study evaluated the efficacy of one of the modules, a 2-hour interprofessional SDM training designed to enhance SDM competencies. Methods A cluster randomized controlled trial was conducted with eight District Psyc...

Objective To conduct a theory analysis of shared decision making (SDM) conceptual models relevant to physiotherapy (PT) to help understand theoretical foundations of SDM for the PT discipline. Design A systematic review was used and updated to select models. The theory analysis was conducted following Walker and Avant’s approach and relevance to s...

The purpose of this study was to explore parents' and health care professionals' perception of parents' experiences in making decisions between acute and palliative therapies along the trajectory of their child's life-limiting condition. An interpretive description qualitative study was conducted. Semistructured interviews were completed with 6 par...

Shared decision-making (SDM) has been advocated to improve patient care, patient decision acceptance, patient-provider communication, patient motivation, adherence, and patient reported outcomes. Documentation of SDM is endorsed in several society guidelines and is a condition of reimbursement for selected cardiovascular and cardiac arrhythmia proc...

Background MyDiabetesPlan is a web-based, interactive patient decision aid that facilitates patient-centred, diabetes-specific, goal-setting and shared decision-making (SDM) with interprofessional health care teams. Objective Assess the feasibility of (1) conducting a cluster randomized controlled trial (RCT) and (2) integrating MyDiabetesPlan int...

Background: Decision coaching is non-directive support delivered by a healthcare provider to help patients prepare to actively participate in making a health decision. 'Healthcare providers' are considered to be all people who are engaged in actions whose primary intent is to protect and improve health (e.g. nurses, doctors, pharmacists, social wo...

Background: High-quality evidence is needed on the effectiveness of total and partial knee arthroplasty (TKA, PKA) compared to other non-surgical treatments to better informed patients considering surgery. The aim is to assess the benefits and harms of TKA/PKA for people with moderate to severe osteoarthritis compared to non-surgical interventions...

Background: In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years. Methods: We conduct...

Introduction Utilizing a qualitative phenomenological design, the Defining Successful Outcomes and Trade-offs study examined stakeholder perspectives regarding optimal healthcare delivery and outcomes for individuals with a difference/disorder of sex development (DSD). Objective We describe study methods and provide an overview of themes and subth...

Background Achilles tendon ruptures are common injuries in an otherwise healthy, active population. Several treatment options exist, with both surgical and non-surgical options. Each treatment option has a unique set of risks and harms, which may present patients with decisional conflict. The aim of the proposed study is to develop, alpha test and...

Introduction: Train-the-trainer (TTT) programs are frequently used to facilitate knowledge dissemination. However, little is known about the effectiveness of these programs. Therefore, we sought to assess the impact of TTT programs on learning and behavior of trainers for educating health and social professionals (trainees). Methods: Guided by t...

Background: The objective of this International Patient Decision Aids Standard (IPDAS) review is to update and synthesize theoretical and empirical evidence on how balanced information can be presented and measured in patient decision aids (PtDAs). Methods: A multidisciplinary team conducted a scoping review using 2 search strategies in multiple...

Objectives To determine the effectiveness of patient decision aids (PtDAs) compared to alternative interventions (including usual care) on decision quality and quality of the decision-making process for adults with hip and knee osteoarthritis considering primary elective total joint arthroplasty. Methods A systematic review guided by Cochrane meth...