Abstract
BackgroundAlthough a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery.MethodsEighty patients with CTS were randomized into two groups. The test group was given a decision aid in addition to regular information and the control group regular information only. The decision aid consisted of a 6-min videoclip that explains diagnosis and information regarding surgery for CTS with other treatment options. We evaluated patients’ decisional conflict regarding surgery, knowledge about CTS, and symptom severity as measured by the Disabilities of Arm, Shoulder, and Hand (DASH) Questionnaire.ResultsThere was no difference in the decisional conflict scale (DCS) between both groups (p = 0.76). The test group had significantly better knowledge than the control group (p = 0.04). There was no correlation between the knowledge score and the DCS (p = 0.76). However, less severe symptoms were correlated with greater decisional conflict (r = −0.29, p = 0.02).ConclusionsWe found that a decision aid does not reduce decisional conflict in patients with CTS, although it can help them be better informed. This study suggests that although a decision-aid is effective for patient education, doctor-patient communication should be more emphasized for patients with less severe symptoms, as they can have greater decisional conflict.Trial RegistrationSNUBH Registry 1510/317-003 Registered November 13, 2015
Highlights
A model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making
Both groups were comparable in terms of demographic characteristics, education, comorbidities, history of a previous operation, symptom duration, and symptom severity assessed with DASH scores (Table 2)
The decisional conflict scores did not differ between the decision aid and the control groups (22 vs. 23, p = 0.76)
Summary
A model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery. Patients with CTS can receive information from a variety of sources, including the Internet, magazines, pamphlets, and TV programs. A decision aid is proposed in order to provide information to patients and to involve patients in the surgical decision-making process [12]. The effect that a decision aid has on patients’ decisional conflict in their decision-making has not been investigated. We aimed to determine whether a decision aid helps patients with CTS experience less decisional conflict regarding their decisionmaking for surgery
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