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首页> 外文期刊>Journal of Hand Surgery. American Volume >A Randomized Controlled Trial of Decision Aids for Upper-Extremity Conditions
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A Randomized Controlled Trial of Decision Aids for Upper-Extremity Conditions

机译：对上肢条件的决策助剂的随机对照试验

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Purpose Decision aids (DAs) are tools designed to correct misconceptions, help people weigh the pros and cons of each option, and choose an option consistent with their values. This randomized controlled trial tested the difference in decision regret between patients who reviewed a DA at the end of the visit and those who did not. Secondary study questions addressed differences in pain self-efficacy, pain intensity, satisfaction, physical function, and treatment choice. Methods We enrolled 147 patients who visited an orthopedic upper-extremity surgeon for a condition that could be treated surgically or nonsurgically. We randomized 76 of these patients to review a DA as part of the visit (52%). At baseline, we measured results using the Pain Self-Efficacy short form, PROMIS Physical Function computer adaptive test, pain intensity on an 11-point ordinal scale, and satisfaction with the visit on an 11-point ordinal scale, as well as whether patients understood all received information and felt adequately educated to decide (no/yes), and choice of surgery, injection, or another treatment. Four to six weeks later, the survey by phone consisted of the PROMIS Physical Function computer adaptive test, pain intensity, satisfaction with the visit, the sense of a well-informed decision, and the Decision Regret Scale. We assessed factors independently associated with each measure. Results People who reviewed a DA had significantly less decision regret 4 to 6 weeks after the visit compared with those who did not. High pain self-efficacy was associated with lower likelihood to choose surgery during the initial visit, better physical function rates, and lower reported pain. Conclusions Decision aids reduce decision regret, which suggests that they help people organize their thoughts and make decisions more consistent with their values. Clinical relevance Hand surgeons can consider the use of DAs as a method for improving the quality of shared decisions. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.)
机译：目的决策辅助工具（DAs）是一种旨在纠正误解、帮助人们权衡每个选项的利弊并选择符合其价值观的选项的工具。这项随机对照试验测试了在就诊结束时复查DA的患者与未复查DA的患者在决定后悔方面的差异。次要研究问题涉及疼痛自我效能、疼痛强度、满意度、身体功能和治疗选择方面的差异。方法我们招募了147名患者，他们因可通过手术或非手术治疗的疾病就诊于矫形外科上肢外科医生。我们将其中76名患者随机分为两组，作为随访的一部分（52%）对DA进行回顾。在基线检查时，我们使用疼痛自我效能简表、PROMIS身体功能计算机适应性测试、11点序贯量表上的疼痛强度、11点序贯量表上的就诊满意度，以及患者是否理解所有收到的信息，并认为有足够的教育来决定（否/是），以及选择手术、注射或其他治疗。四到六周后，通过电话进行的调查包括PROMIS身体功能计算机适应性测试、疼痛强度、就诊满意度、知情决定感和决定后悔量表。我们独立评估了与每项测量相关的因素。结果与未进行DA检查的人相比，在就诊后4至6周复查DA的人对决定的后悔明显减少。高疼痛自我效能感与初次就诊时选择手术的可能性较低、身体功能良好率和报告的疼痛较低有关。结论：决策辅助工具可以减少决策后悔，这意味着它们可以帮助人们组织自己的想法，并使决策更符合他们的价值观。临床相关性手外科医生可以考虑使用DAS作为一种方法来提高质量的共同决策。版权所有（C）2021美国外科学会的手。版权所有。）

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