ABSTRACT
OBJECTIVE: The objective of the review was to determine the effectiveness of the use of decision aids to facilitate the shared decision-making process between a person and a healthcare provider on smoking cessation rates, knowledge of smoking cessation methods and decisional quality. INTRODUCTION: The tobacco epidemic is one of the biggest health threats in the world, and it is the single most important preventable cause of disease. In the smoking cessation process, people move through different stages in their readiness to quit. Healthcare providers are well positioned to impact smoking cessation, however, challenges continue to exist. Using decision aids in the smoking cessation decision-making process may be one means in moving people toward the decision to quit smoking. INCLUSION CRITERIA: The review considered randomized controlled trials and quasi-experimental studies which included adults, 18 years and over, who smoke tobacco products. The intervention of interest was implementation of decision aids to promote shared decision-making related to smoking cessation. The comparator was usual care without the use of decision aids. Outcomes of interest were smoking abstinence, smoking quit attempts, knowledge of smoking cessation methods and decisional quality. METHODS: A comprehensive search was undertaken to locate relevant published and unpublished quantitative English language studies from the inception of each database searched through July 30, 2017. Databases searched included: CINAHL, Cochrane Central Register of Controlled Trials, Embase, PsycINFO and PubMed. A search of gray literature was also performed. Titles and abstracts were screened by two independent reviewers for assessment against the inclusion criteria. Studies meeting the inclusion criteria were retrieved in full and assessed in detail against the inclusion criteria by two independent reviewers. Two reviewers independently evaluated the included studies for methodological quality using critical appraisal tools from the Joanna Briggs Institute (JBI). Data related to the methods, participants, interventions and findings were extracted by two independent reviewers using a standardized data extraction tool from JBI. Due to clinical and methodological heterogeneity in the interventions and outcome measures of the included studies, statistical meta-analysis was not possible. Results have been presented in narrative form. RESULTS: Eight papers representing seven unique studies evaluating smoking cessation decision aids were included. Of the six studies that measured abstinence, only two had positive findings, with one reaching statistical significance. The fours studies that measured quit attempts all demonstrated a trend toward an increase in the number of quit attempts, with one study reaching statistical significance. Four of the five studies that measured knowledge reported an initial increase in the knowledge of smoking cessation methods, with two studies reaching statistical significance. Two of the three studies that measured decisional quality showed an improvement in decisional quality after use of the decision aid, with one study reaching statistical significance. CONCLUSIONS: The evidence suggests that decision aids may be effective in increasing smoking cessation knowledge and decisional quality while increasing quit attempts. There is, however, inconclusive evidence to support the definitive effectiveness of decision aids for long term and sustained smoking cessation.
Subject(s)
Decision Making , Decision Support Techniques , Health Knowledge, Attitudes, Practice , Patient Education as Topic , Professional-Patient Relations , Smoking Cessation/methods , Tobacco Smoking/prevention & control , Adolescent , Adult , Health Personnel , HumansABSTRACT
Early advance care planning and anticipatory decision making in the Alzheimer disease (AD) trajectory is a strategy NPs can incorporate to improve managing uncertainty around common decisions. This article explores decisions patients and caregivers face along the AD trajectory and provides resources for patients, caregivers, and NPs.
Subject(s)
Advance Care Planning , Alzheimer Disease/nursing , Decision Making , Caregivers/psychology , Humans , Nurse Practitioners , Nurse-Patient RelationsABSTRACT
REVIEW QUESTION: The objective of this review is to determine the effectiveness of the use of decision aids in a shared decision-making encounter between any healthcare provider and adult patients who smoke, compared to standard education on smoking cessation, in any healthcare setting.Specifically, the review questions are: What is the effectiveness of the use of decision aids in a shared decision-making encounter in any healthcare setting between the healthcare provider and adult patients who smoke compared to standard education, based on the patient's.
