Application of shared decision making-based intervention in stable coronary artery disease patients with decisional conflict / 中国实用护理杂志

Object:To explore the effects of shared decision making-based intervention on decisional conflict and health literacy in stable coronary artery disease patients.Methods:A total of 86 stable coronary artery disease patients were divided into experimental group and control group according to the admission order, with 43 cases in each group. The patients in the control group recieved routine nursing, basis on this, the experimental group carried out shared decision making program. Before and after 1 month of intervention, the effects was assessed by Decisional conflict scale (DCS) and Health literacy management scale (HeLMS), respectively.Results:Before intervention, there was no significant difference in DCS and HeLMS scores between two group( P>0.05). After intervention, the information & values, decision uncertainty and total DCS scores were (6.95±2.13) pionts, (3.44±1.18) pionts and (20.95±3.99) pionts, significantly lower than in the control group (8.77±2.33) pionts, (4.95±1.46) pionts, (25.56±4.03) pionts; the information acquisition ability, interaction ability, willingness to improve health, willingness of financial support and total HeLMS scores were (36.77±4.85) pionts, (35.74±4.58) pionts, (15.07±1.55) pionts, (6.53±1.76) pionts, (94.12±6.44) pionts, significantly higher than in the control group [(34.37±5.84) pionts, (33.19±5.90) pionts, (14.23±1.43) pionts, (5.81±1.29) pionts, (87.60±9.18) pionts], the difference was statistically significant ( t values were 2.070-5.321, P<0.05). Conclusion:Shared decision making can effectively alleviate decisional conflict and improve health literacy of patients with stable coronary artery disease.

Conflicto decisional en salud en mujeres cuidadoras / Health decisional conflict in female care givers

Objetivos: la población de mujeres cuidadoras es un grupo que por sus características necesita especialmente ser estudiada respecto a las variables que están involucradas en los conflictos decisionales de salud a los que se enfrentan. Para ello se plantearon dos objetivos: captar la esencia de variables latentes de conflicto decisional en salud en mujeres cuidadoras informales. Construir tipologías de mujeres que experimentan este conflicto en salud, en una muestra de 50 mujeres de la Comuna de Concepción, Chile. Métodos: se realizó un estudio exploratorio, utilizando la técnica de análisis factorial para variables categóricas, seguido por un análisis de clasificación. Resultados: los resultados arrojaron 2 dimensiones, una que se interpretó como conocimientos para enfrentar el conflicto y la segunda como recursos personales que favorecen la toma de decisión. Conclusiones: el análisis de clasificación permitió identificar 4 grupos distintos de mujeres cuidadoras que enfrentan conflictos decisionales(AU)

Objetives: the population of female care givers is a group that due to their characteristics need to be specially studied as regards the variables involved in the health decisional conflicts they have to face. Two goals were established to this end: to capture the essence of latent variables of health decisional conflict in informal care givers, and to construct typologies of women experimenting this conflict in health, in a sample of 50 females from Comuna de la Concepción, Chile. Methods: an exploratory study was conducted by using the technique of factorial analysis for categorical variables, followed by a classification analysis. Results: the results showed 2 dimensions, one that was interpreted as knowledge to face the conflict and the second as personal resources that favor the decision-making. Conclusions: the classification analysis allowed to identify 4 different groups of female care givers that face decisional conflicts(AU)

Decisional Conflict about Hormone Replacement Therapy in Postmenopausal Women and Its Related Factors

BACKGROUND: Since the Women's Health Initiative (WHI) study indicated that the significant risks are associated with hormone replacement therapy (HRT), it has been highly expected that postmenopausal women have decisional conflict about HRT. We investigated how much decisional conflict women have in taking HRT and what factors were associated with this conflict. METHODS: A total of 312 postmenopausal women, who had been on HRT or just began, were surveyed from May 10 to June 27, 2005. The subjects were asked by questionnaire that included demographic characteristics and factors related to decisional conflict. Decisional conflict was assessed using the Decisional Conflict Scale (DCS) composed of 16 items. RESULTS: The mean score of DCS was 2.61, which was severe and lack of support from friends and relatives was the most common major conflicting factor. Forty-five percent of the participants started HRT by doctor's recommendation, but had a higher decisional conflict compared to those who started on their own or by encouragement from family and friends. Women who were exposed to mass-media or who had discontinued HRT previously had a lower conflict. Higher the educational level and longer the duration of HRT before stopping lowered decisional conflict. DCS was not significantly influenced by age, income, menopausal symptoms, duration of HRT and the history of hysterectomy. CONCLUSION: Postmenopausal women when making a decision to begin HRT had high conflict. The factors related to conflict were educational level, exposure to mass-media, and motivation to begin therapy. Therefore, adequate and continued counseling with doctors may reduce women's decisional conflict about HRT.