Randomized trial of a portable, self-administered decision aid for postmenopausal women considering long-term preventive hormone therapy

被引:177
作者
O'Connor, AM
Tugwell, P
Wells, GA
Elmslie, T
Jolly, E
Hollingworth, G
Mcpherson, R
Drake, E
Hopman, W
Mackenzie, T
机构
[1] Ottawa Civic Hosp, Clin Epidemiol Unit, Loeb Res Inst, Ottawa, ON K1Y 4E9, Canada
[2] Univ Ottawa, Fac Med, Ottawa, ON, Canada
[3] Univ Ottawa, Sch Nursing, Ottawa, ON, Canada
[4] Queens Univ, Dept Epidemiol & Community Hlth, Kingston, ON, Canada
关键词
decision making; choice behavior; informed consent; decision-support techniques; woman education; woman participation; health education; consumer satisfaction; hormone replacement therapy; menopause;
D O I
10.1177/0272989X9801800307
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Although practice guidelines suggest that postmenopausal women learn about the benefits and risks and consider their values when deciding about hormone therapy, the optimal decision-support method has not been established. In a randomized controlled trial, the authors compared the efficacy of a general educational pamphlet with that of a tailored decision aid. The pamphlet briefly summarized benefits, risks, and likely beneficiaries in general terms. The decision aid, delivered via booklet and audiotape, provided: detailed benefits and risks using functional terms and probabilities tailored to clinical risk; and steps for considering the issue in a woman's own situation, including a value-clarification exercise. Compared with the pamphlet group, the decision-aid group had statistically significant (p < 0.05) improvements in terms of realistic personal expectations of the benefits and risks, decisional conflict, and perceived acceptability of the intervention. Levels of general knowledge about the main benefits and risks were comparable for the two interventions. It is concluded that tailored decision aids prepare women for decision making better than do general pamphlets. .
引用
收藏
页码:295 / 303
页数:9
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