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Lookup NU author(s): Jan Lecouturier, Professor Gerard Stansby, Emeritus Professor Richard Thomson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2023 Public Library of Science. All rights reserved. Introduction Shared decision making (SDM) refers to patients and health care professionals working together to reach a decision about treatment/care. In abdominal aortic aneurysm (AAA) treatment options are influenced by patients’ clinical characteristics, their preferences, and potential trade-offs between alternative interventions. This is a prime example of where SDM is essential to ensure the right decision is made for the right patient, yet we have little understanding of what happens in practice. This study explored patient experiences to understand SDM practice in AAA surgery. Methods We used a qualitative approach to describe, and identify improvements to, current treatment decision making in abdominal aortic aneurysm (AAA) surgery. Two groups of patients were interviewed: those at the point of discussing treatment options (with corresponding digitally recorded consultation data) and following surgical intervention from one hospital. Framework analysis was used. Results Fifteen patients were interviewed, seven at the point of discussing treatment options and eight following surgical intervention. Timing, format and sources of information, verbal framing of interventions and level of patient engagement were key themes. Four areas for improvement were identified: earlier provision and more detailed written information along with signposting to quality on-line information; both intervention options, risks, benefits, and consequences, were not always discussed; some clinicians were somewhat directive in the decision-making process; and patients’ treatment values/preferences were not explored–the only example was in one of the eight recorded consultations. Patients could feel overwhelmed by the information and decision and fearful of the impending surgery. Conclusions More emphasis should be placed on the provision of full information and the exploration of patient values and preferences for treatment. Clinician training and support for patients, including decision aids, could facilitate the decision-making process. Providing written information earlier and guidance on reliable on-line resources would benefits patients and their families.
Author(s): Lecouturier J, Stansby G, Thomson RG
Publication type: Article
Publication status: Published
Journal: PLoS ONE
Year: 2023
Volume: 18
Issue: 10
Online publication date: 23/10/2023
Acceptance date: 11/10/2023
Date deposited: 06/11/2023
ISSN (electronic): 1932-6203
Publisher: Public Library of Science
URL: https://doi.org/10.1371/journal.pone.0293354
DOI: 10.1371/journal.pone.0293354
PubMed id: 37871042
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