Internet Versus DVD Decision Aids for Hip and Knee Osteoarthritis
Internet Versus DVD Decision Aids for Hip and Knee Osteoarthritis
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DOI：
10.1002/msc.1116
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发表时间：
2016-06-01
影响因子：
1.3
通讯作者：
Williams, John W., Jr.
中科院分区：
文献类型：
--
作者：
Allen, Kelli D.;Sanders, Linda L.;Williams, John W., Jr.
简介：决策辅助工具（DA）可以改善多种决策结果，但目前尚不清楚不同的交付形式是否在其有效性或可接受性方面有所不同。本研究比较了互联网和DVD格式的DA的有效性和可接受性骨关节炎（OA）。方法：髋关节或膝关节OA患者随机查看互联网或DVD格式的DA，提供有关OA治疗的信息。在基线、查看DA后立即和30天后收集测量值。成果包括：髋关节/膝关节OA决策质量量表-知识子量表（HK-DQI知识）、决策冲突量表（DCS）、决策准备量表（PDMS）、决策阶段和DA的可接受性。广义估计方程（GEE）被用来检查HK-DQI知识和DCS分数随时间的变化，决策辅助组之间和样本整体。在PDMS量表（评估一次，DA查看后立即）的组间差异估计使用Wilcoxon秩和test.Results：在研究的155名参与者中，平均年龄为61.8岁，60.6%是女性和58.1%是白人。HK-DQI知识评分随着时间的推移而改善（p< 0.001），尽管在30天随访时有一些衰减;两个DA组之间没有差异（p = 0.448）。两组的DCS评分均显著降低（p< 0.001），并在30天随访时保持改善（平均值：互联网：基线= 25.0，30天= 6.9; DVD：基线= 25.0，30天= 6.2）;两个DA组之间无差异（p = 0.808）。DVD组的PDMS评分高于互联网组（85.2 vs 74.9，p = 0.005）。在查看两组的DA后，决策阶段变得更加确定，在30天随访时甚至更加确定。可接受性项目表明积极的看法，两个DAS.Discussion：互联网和DVD DA与有意义的，可比的改善，在膝关节和髋关节OA患者的决策结果。DA的传播成本低廉，可能是加强OA护理的有价值的工具。版权所有（C）2015约翰威利父子有限公司
Introduction: Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of internet and DVD formats of DAs for osteoarthritis (OA).Methods: Patients with hip or knee OA were randomized to view an internet or DVD format DA, which provided information on OA treatments. Measures were collected at baseline, immediately after viewing the DA and then 30 days later. Outcomes included: Hip/Knee OA Decision Quality Instrument - Knowledge Subscale (HK-DQI Knowledge), Decisional Conflict Scale (DCS), Preparation for Decision Making Scale (PDMS), Stage of Decision Making, and Acceptability of DAs. Generalized estimating equations (GEE) were used to examine changes in HK-DQI Knowledge and DCS scores over time, between decision aid groups and within the sample overall. Group differences in the PDMS scale (assessed once, immediately after DA viewing) were estimated using a Wilcoxon rank sums test.Results: Among 155 participants in the study, the mean age was 61.8 years, 60.6% were women and 58.1% were Caucasian. HK-DQI Knowledge scores improved over time (p< 0.001), although there was some attenuation by the 30-day follow-up; there was no difference between the two DA groups (p = 0.448). DCS scores decreased markedly for both groups (p< 0.001) and improvements were maintained by the 30-day follow-up (means: internet: baseline = 25.0, 30-day = 6.9; DVD: baseline = 25.0, 30-day = 6.2); there was no difference between the two DA groups (p = 0.808). PDMS scores were higher for the DVD group than the internet group (85.2 versus 74.9, p = 0.005). Stage of Decision Making became more certain after viewing the DA for both groups, with even more certainty indicated at 30-day follow-up. Acceptability items indicated positive perceptions of both DAs.Discussion: Internet and DVD DAs were associated with meaningful, comparable improvements in decision-making outcomes in patients with knee and hip OA. DAs are inexpensive to disseminate and could be valuable tools for enhancing care for OA. Copyright (C) 2015 John Wiley & Sons, Ltd.