Abstract
BackgroundPosttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness. There are multiple treatments for PTSD that have similar effectiveness, but these treatments differ substantially in other ways. It is desirable to have well-informed patients involved in treatment choices. A patient decision aid (PtDA) is one method to achieve this goal. This manuscript describes the rationale and development of a patient decision aid (PtDA) designed for patients with PTSD.MethodsWe conducted an informational needs assessment of veterans (n = 19) to obtain their baseline information needs prior to the development of the PtDA. We also conducted a literature review of effective PTSD treatments, and we calculated respective effective sizes. A PtDA prototype was developed according to the guidelines from the International Patient Decision Aid Standards. These standards guided our development of both content and format for the PtDA. In accordance with the standards, we gathered feedback from patients (n = 20) and providers (n = 7) to further refine the PtDA. The information obtained from patients and the literature review was used to develop a decision aid for patients with PTSD.ResultsPatients with PTSD reported a strong preference to receive information about treatment options. They expressed interest in also learning about PTSD symptoms. The patients preferred information presented in a booklet format. From our literature review several treatments emerged as effective for PTSD: Cognitive Therapy, Exposure Therapy, Eye Movement Desensitization Therapy, Selective Serotonin Reuptake Inhibitors, venlafaxine, and risperidone. ConclusionIt appears that the criteria set forth to develop decision aids can effectively be applied to PTSD. The resultant PTSD patient decision aid is a booklet that describes the causes, symptoms, and treatments for PTSD. Future work will examine the effects of use of the PTSD decision aid in clinical practice.Trial registrationClinicaltrials.gov identifier NCT00908440. Registered May 20, 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0724-x) contains supplementary material, which is available to authorized users.
Highlights
Posttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness
One veteran stated, “I don’t even know what the doctor means by Posttraumatic stress disorder (PTSD)...which of my problems are PTSD?” Another participant asked, “What I want to know is what this stress thing is doing to my heart.”
We developed a patient decision aid (PtDA) designed for participants with PTSD that reflected their informational needs and current knowledge about effective treatments
Summary
Posttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness. A patient decision aid (PtDA) is one method to achieve this goal. This manuscript describes the rationale and development of a patient decision aid (PtDA) designed for patients with PTSD. Symptoms of PTSD fall into four categories. These include intrusion symptoms (e.g., intrusive thoughts, nightmares and flashbacks), avoidance (i.e., avoiding thoughts, feelings, and people/places related to the traumatic event), negative alterations in mood (inability to remember, distorted cognitions, guilt), and arousal symptoms (e.g., irritability, trouble sleeping, hyperarousal, and startle reflex) [1].
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