The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse

Mette Hulbæk, Jette Primdahl, Jesper Bo Nielsen, Niels Ebbesen, Regner Birkelund

Publikation: Konferencebidrag uden forlag/tidsskriftKonferenceabstrakt til konferenceForskningpeer review

Abstract

Background and aims
In Denmark app. 4-5000 women annually have surgery for their pelvic organ prolapse (POP). More than one treatment option for symptoms from POP exists, and it can be challenging to establish to what extent these symptoms fully originate from the objective prolapse and what impact other components may have on the symptoms. Both objective as well as subjective components are important in order finding the best treatment choice. In this multicriterial context, women may need support to prepare and empower them to participate in a shared decision making about choice of treatment. It is important to support participation in the decision making process for these women in order to individualize the treatment choice making and to systematize the way these women’s preferences are included in the decision making. Decision aids (DA) are used to support an informed choice and patients’ participation in decision making.
The aim of this study is to develop a DA for women with POP based upon a multicriteria decision approach in an online program. The DA is built by and based upon identification of criteria important for women with POP and for health care persons involved in the decision making process.
A brief description of methods
The DA is developed through conceptualizing the users’ needs and through pretesting of the DA in a participatory design process. Furthermore the development follows international standards for DA (IPDAS). The data derive from literature search, field observations, thematic text analysis of patient interviews and of workshop outputs from clinicians (doctors, nurses and physiotherapists). Clinical comprehensibility, feasibility and acceptability of the DA in the clinical decision making process during consultation are alfa- and beta tested by patients as well as clinicians during the development phase.
The DA is developed and tested at five gynecological clinics – from both urban and rural hospitals in Denmark.
A brief summary of results to support conclusions
Data collection from patients and clinicians revealed important aspects of relevance for choice of treatment. The aspects can be divided into six main symptom criteria of importance (i) bowel function, (ii) micturion function, (iii) symptoms of vaginal bulging and pressure, (iv) body awareness (v) problems with sexual function, (vi) side effects. Besides these criteria patients reported more emotional aspects related to anxiety, uncertainty about treatment options, pro and cons (trade-offs) with different treatment options, and the ‘investment’ (such as time investment e.g. sick leave) in each treatment.
Conclusions
Three overall domains are important for Danish women with POP; 1) symptom relief in the light of variation and intensity of symptoms and coherence of symptoms 2) sufficient information to assure emotional stability and 3) impact of treatment on short as well as long-term life quality.
The online DA with a multicritial approach and reconceptualized for women with POP will be pilot tested in a hospital setting at the point of decision during clinical consultations to ensure feasibility and acceptability of the DA before final adjustments and prototyping (summer 2017).
OriginalsprogEngelsk
Publikationsdato26. apr. 2017
Antal sider1
StatusUdgivet - 26. apr. 2017
Begivenhed9th International Shared Decision Making Conference - Lyon, Frankrig
Varighed: 2. jul. 20175. jul. 2017
Konferencens nummer: 9
http://9th International Shared Decision Making Conference

Konference

Konference9th International Shared Decision Making Conference
Nummer9
Land/OmrådeFrankrig
ByLyon
Periode02/07/201705/07/2017
Internetadresse

Emneord

  • decision aids

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