Helping women make choices about mammography screening: An online randomized trial of a decision aid for 40-year-old women
Helping women make choices about mammography screening: An online randomized trial of a decision aid for 40-year-old women
复制标题
DOI：
10.1016/j.pec.2010.01.001
复制
发表时间：
2010-10-01
影响因子：
3.5
通讯作者：
Houssami, Nehmat
中科院分区：
文献类型：
--
作者：
Mathieu, Erin;Barratt, Alexandra L.;Houssami, Nehmat
目的：为了评估的影响，决策援助（DA）对妇女的知识的好处和危害的筛选和他们的能力，使知情decision.Methods：321名妇女年龄在38-45岁之间的一个在线随机对照试验进行。参与者被随机分配到即时或延迟访问在线DA，其中（i）解释了好处和危害，（ii）包括价值澄清练习和支持决策的工作表。主要结局，筛查的益处和危害的知识，以及次要结局，知情选择（知识、价值观和意向的综合）、焦虑和DA的可接受性采用在线问卷进行测量。干预组的女性比男性（10分中的平均分，7.35比6.27，p < 0.001），更有可能做出决定（82%比61%，p < 0.001）。在那些做出决定的人中，干预组的妇女现在开始筛查的可能性较小（52% vs 65% p = 0.05）。知情选择的女性比例没有显著差异（干预组为71%，对照组为64%，p = 0.24）。DA是有帮助的，平衡和明确的，并没有使妇女anxious.Conclusions：DA增加知识和减少犹豫不决，而不增加的感觉anxious.Practice的影响：这种决策援助是很容易获得在线，可能是一种廉价的方式支持妇女40岁的人正在考虑是否现在开始筛查，或等到他们50。这项研究的结果表明，DA的潜力，以帮助妇女了解在这个年龄筛查的好处和风险，并支持妇女和临床医生在这一决策过程。(C)2010爱思唯尔爱尔兰有限公司版权所有。
Objective: To evaluate the effect of a decision aid (DA) on women's knowledge of the benefits and harms of screening and on their ability to make an informed decision.Methods: An online randomized controlled trial among 321 women aged 38-45 years was conducted. Participants were randomized to either immediate or delayed access to the online DA which (i) explained the benefits and harms, (ii) included a values clarification exercise and a worksheet to support decision making. The primary outcome, knowledge of benefits and harms of screening, and secondary outcomes, informed choice (composite of knowledge, values and intention), anxiety and acceptability of the DA were measured using online questionnaires.Results: Women in the intervention group were more knowledgeable (mean score out of 10, 7.35 vs 6.27, p < 0.001) and were more likely to have made a decision (82% vs 61% p < 0.001). Of those who made a decision, women in the intervention group were less likely to start screening now (52% vs 65% p = 0.05). There was no significant difference in the proportion of women who made an informed choice (71% intervention group vs 64% control group, p = 0.24). The DA was helpful, balanced and clear, and did not make women anxious.Conclusions: The DA increased knowledge and reduced indecision, without increasing feelings of anxiety.Practice Implications: This decision aid is easy to access online and could be an inexpensive way of supporting women aged 40 who are considering whether to start screening now, or wait until they are 50. The results of this study demonstrate the potential of DAs to help inform women about both the benefits and risks of screening at this age and to support women and clinicians in this decision making process. (C) 2010 Elsevier Ireland Ltd. All rights reserved.