Values Clarification Research Articles

Observer Ratings of Shared Decision Making Do Not Match Patient Reports: An Observational Study in 5 Family Medicine Practices.

Measuring shared decision making (SDM) in clinical practice is important to improve the quality of health care. Measurement can be done by trained observers and by people participating in the clinical encounter, namely, patients. This study aimed to describe the correlations between patients' and observers' ratings of SDM using 2 validated and 2 nonvalidated SDM measures in clinical consultations. In this cross-sectional study, we recruited 238 complete dyads of health professionals and patients in 5 university-affiliated family medicine clinics in Canada. Participants completed self-administered questionnaires before and after audio-recorded medical consultations. Observers rated the occurrence of SDM during medical consultations using both the validated OPTION-5 (the 5-item "observing patient involvement" score) and binary questions on risk communication and values clarification (RCVC-observer). Patients rated SDM using both the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and binary questions on risk communication and values clarification (RCVC-patient). Agreement was low between observers' and patients' ratings of SDM using validated OPTION-5 and SDM-Q9, respectively (ρ = 0.07; P = 0.38). Observers' ratings using RCVC-observer were correlated to patients' ratings using either SDM-Q9 (rpb = -0.16; P = 0.01) or RCVC-patients (rpb = 0.24; P = 0.03). Observers' OPTION-5 scores and patients' ratings using RCVC-questions were moderately correlated (rφ = 0.33; P = 0.04). There was moderate to no alignment between observers' and patients' ratings of SDM using both validated and nonvalidated measures. This lack of strong correlation emphasizes that observer and patient perspectives are not interchangeable. When assessing the presence, absence, or extent of SDM, it is important to clearly state whose perspectives are reflected.

The Challenges Introducing Students to a Life Design Attitude

Students of today are faced with the reality of an unpredictable working life in a constantly turbulent and fast-changing world. This has led to an intense focus on entrepreneurship. Yet, we seem to overlook the fact that students are increasingly challenged by stress and depression. We need to rethink education to include knowledge and tools not only for creating a job, but for reshaping life in general. This paper is part of a larger body of research aimed at introducing students to a Life Design Attitude. Research has proved that design can be used in value clarification and lead to changes in inappropriate beliefs and behaviour. In other words, design can be used to create better lives. However, by comparing data from three workshops this paper concludes that prior to introducing students to a design attitude to life there is an urgent need for a renewed understanding of creativity in educational institutions.

Translating a Group-Based Dyadic Intervention for Early-Stage People and Their Care Partners for Spanish Speakers

This presentation focuses on the development of and recruitment for a Spanish language version of EPIC, a group-based dyadic intervention for people with early-stage dementia (EPs) and their care partners (CPs). EPIC involves activities for the entire group together, separate EP or CP groups, and one individualized session for each dyad. EPIC builds on components of SHARE combined with strategies from other psychoeducational interventions (e.g., skills-training, care values clarification, care planning). Findings from 6 focus groups with Latino participants were used to help with cultural responsiveness such as fluent Spanish/bilingual staff, testimonials from Latino families affected by dementia, and minimization of “threatening” language for memory loss. Participants also provided suggestions for recruitment for Spanish speakers such as engaging promotores, using social media across generations, recruiting through Spanish language health classes, and recognizing the impact of the political environment. The presentation will review both recruitment successes and challenges using these approaches.

An Autonomy-Supportive Online Decision Aid to Assist Smokers in Choosing Evidence-Based Cessation Assistance: Development Process and Protocol of a Randomized Controlled Trial.

BackgroundDecision aids (DAs) may be used to facilitate an autonomous, informed decision to cease smoking and promote the uptake of evidence-based cessation assistance (ie, behavioral support, nicotine replacement therapy, or prescription medication). However, knowledge is lacking regarding their effective elements and (cost-)effectiveness.ObjectiveWe describe the development process of an online DA (called “VISOR”) that helps smokers to choose evidence-based cessation assistance. Additionally, we provide a description of the protocol of an ongoing randomized controlled trial in which the DA containing an explicit value clarification method (VCM) and tailored advice is compared with a DA without an explicit VCM and tailored advice.MethodsThe development of “VISOR” was based on the International Patient Decision Aid Standards guidelines. Viewpoints of end users (collected through 20 interviews with smokers) and clinical and scientific experts (assessed using 2 Delphi studies with 24 scientists and 38 clinicians) were assessed regarding cessation tool decision making and preferred DA content. These findings, together with principles from the Self-Determination Theory, served as input for the development of the online DA. A first DA prototype was alpha-tested in September 2019 and beta-tested for usability in December 2019; feedback was incorporated and resulted in a final version. The final DA contains (1) an information section, (2) an optional knowledge quiz, (3) a brief smoking assessment, (4) intuitive decision, (5) intermediate advice, (6) an explicit VCM, (7) tailored advice, and (8) access information. A randomized controlled trial is currently being conducted to assess the DA’s (cost-)effectiveness compared to a DA that does not include the explicit VCM and the tailored advice; specifically, the DA’s effect on smoking abstinence, uptake of evidence-based cessation assistance, smoking abstinence mediated through uptake of evidence-based cessation assistance, and decisional conflict are investigated. Participants are randomly allocated to receive access to 1 of the 2 DAs and are asked to complete 5 questionnaires (including the baseline questionnaire) over a period of 12 months. To evaluate the effects of the DA on the outcome measures, logistic and linear regression analyses as well as mediation analyses will be carried out. An economic evaluation will be performed to assess the cost-effectiveness.ResultsData regarding the effect of the VISOR DA are currently being collected, and data collection is expected to be concluded in 2021.ConclusionsBy making use of an iterative process that integrated different stakeholders’ perspectives (including end users), we were able to systematically design an evidence-based DA. The study will contribute to the current knowledge regarding smoking cessation DA application, the added value of explicit VCMs, and the effect of behavioral and informed decision-making outcomes.Trial RegistrationNetherlands Trial Register NL8270; https://www.trialregister.nl/trial/8270International Registered Report Identifier (IRRID)DERR1-10.2196/21772

PENGARUH PENERAPAN VALUE CLARIFICATION TECHNIQUE (VCT) TERHADAP ECOLITERACY DAN KETERAMPILAN BERPIKIR KRITIS SISWA SEKOLAH DASAR

The purpose of this research was to determine the effect of the application of Value Clarification Technique (VCT) to ecoliteracy and critical thinking skills of elementary school students in learning social study. The method used in this study was a quasi experimental design with non- equivalent control group design, using the two study groups. Subjects in this study were students of class IV Komplek SDN Cijerah Indah, Kecamatan Bandung Kulon Kota Bandung. The experimental group was given the treatment of learning Value Clarification Technique (VCT) and the control group was given conventional learning. The results showed that in general there is a difference between learners ecoliteracy experimental class and control class and critical thinking skills among learners experimental class and control class after each class has been getting treatment that has been set.

Patterns of triggers, ideation and motivational factors of contraceptive utilization among women and gate-keepers in Nigeria: a scoping study on the resilient and accelerated scale up of DMPA-SC in Nigeria (RASUDIN)

BackgroundWomen have unfair share in the burden of unintended pregnancy outcome and unhealthy interpregnancy intervals. An understanding of the triggers, ideation and motivational factors influencing utilization of modern contraceptives is relevant for efforts aimed at increasing utilization among the general public, specifically sexually active women. The objective of this study is to explore the triggers, ideation and motivational factors influencing the use of modern family planning methods including depot-medroxyprogesterone acetate subcutaneous (DMPA-SC).MethodsQualitative methods which include; Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were used to elicit information from women of reproductive age and gate-keepers in selected Nigerian states; Rivers, Ogun, Kwara, Niger, Anambra, Delta, Lagos, Enugu and Oyo. The categories of respondents include; unmarried women aged 18-25 years, women in union aged 18-24 years using modern family planning (FP), women in union aged 25-49 years using modern FP, women in union aged 26-49 years non-users of modern FP, community leaders, health facility focal person, husbands of current users of modern FP, husbands of non-users of modern FP, religious leaders, state FP coordinators and women aged 18-49 years who currently use DMPA-SC. Maximum variation sampling techniques was used to enlist participants to participate in both FGDs and IDIs.ResultsRespondents reported being motivated to use FP for reasons such as benefits of the method, economic situation, suitability of the methods, fear of unwanted pregnancy and its convenience. Further analysis showed that the unmarried respondents discussed more about fear of unwanted pregnancy and accessibility and affordability as a key motivator; while women in union discussed more on economic situations, encouragement from partners and benefits of FP when compared with the unmarried. In addition, respondents reported that their partners, health workers and friends influenced their decisions to use FP. Partners’ encouragement, personal experience, accessibility and availability, awareness of FP and its benefits; willingness to space children and costs were notable enablers of FP use. The triggers for FP use were; appointment cards, phone calls from health workers, reminders (text messages, phone alarms and partners’ support).ConclusionIncreasing utilization therefore requires a well-planned horizontal approach that considers all enabling factors influencing utilization including women’s empowerment. Family planning programmes that are client centered, address socio-cultural and gender norms and ensure access to contraceptive mix methods are recommended to improve utilization rate. This study recommends improved care-seeking behaviour through community-based awareness creation to address myths and misconceptions of family planning use, establishment of contraceptive delivery teams to prevent challenges of availability and accessibility, value clarification and tasks shifting among others to deal with the issue of inadequate family planning utilization.

The Influence Of Value Clarification Technique Learning Models Online Based On Afective Learning Outcomes In Historical Learning

<p><em>The improvement of the quality of education is based on the establishment of the quality of learning and the development of technology. The quality of learning is determined by the competence of teachers in managing the classroom. Online learning with various features and applications can be a great alternative for teachers and students to keep interacting without having to come face to face during covid-19. The online-based VCT learning model can provide critical-creative power, fostering positive attitudes, interests, and grades to students in history learning. Therefore, the purpose of this study is to determine the influence of the online-based Value Clarification Technique learning model on the affective learning outcomes of history students. The research method uses quantitative methods with quasi-experimental designs. The population in this study is all grade XI students of Sma Negeri 9 Bogor City. While the sampling technique is purposive sampling which is divided into two classes into experiment groups (XI IPA 3) and control group (XI IPA 1). The data collection method is a multiple-choice test method. The results of this study show that online-based VCT learning models influence students' affective learning outcomes in historical learning.</em></p>

Group Counseling with Values Clarification Techniques to Increase Students' Respect

Individuals must own respect because it can be an internal controller in making logical decisions to behave by moral values. This study aimed to confirm the effectiveness of the values clarification group counselling on respect. This study used a repeated measure experimental design. The subjects in this study were 10 students at SMK Negeri 2 Mataram who indicated having a low category of respect. Data were collected using a respectful attitude questionnaire. Data analysis used repeated measure statistics ANOVA. The results of this study indicate that values clarification group counselling is effective in increasing student respect. Students' understanding regarding respect is inseparable from how to create good relationships between students and teachers as a form of creating a healthy and conducive school climate.

Application of Value Clarification Technique (Vct) Models in Improving Learning Outcomes in Dangerous Goods Regulation

Learning in school or in every educational institution has an important role as a media liaison between knowledge and students or students. There are many learning methods or models used in education. Of the many methods or modes, there is one of them is a clarification value technology (VCT) model. The teaching method is a knowledge of teaching methods used by a teacher or instructor. Another understanding is the presentation technique mastered by the teacher to teach or present learning materials to students in class both individually and in groups. the learning method by clarifying the value of the value clarification technique is teaching to shape students in finding and determining a value that is considered good in dealing with a problem through the process of analyzing existing values and embedded in students. Meanwhile, learning outcomes are abilities students have after they have a learning experience. The purpose of this study is to determine the level of learning outcomes of a particular institution. In this study the object of research from an educational institution that is competent in the field of flight is used. The institution is Surabaya Aviation Polytechnic. The subject of learning taken was Regulation of Dangerous Goods at Surabaya Aviation Polytechnic. In addition, this study was also conducted to determine differences in learning outcomes of cadets in the Lessons on Dangerous Goods Regulations in Surabaya Aviation using the Value Clarification Technique (VCT) method. This type of research is Classroom Action Research (CAR). The research carried out is included in the design of one group pretest and possttest research. the research design that contained pretest before being given treatment and posttest after being treated. This research was conducted at Surabaya Aviation Polytechnic. The data analysis technique used is the different test. Based on data management and analysis results, it can be concluded that the application of learning of Value Clarification Techniques can improve the learning outcomes of cadets. This is evidenced by the differences in learning outcomes of Cycle I and Cycle II significantly

Developing and evaluating a patient decision aid for hormone therapy to manage symptoms of surgical menopause: the story behind the "SheEmpowers" patient decision aid.

To develop and evaluate an evidence-based patient decision aid (PDA) that can support women making decisions on hormone therapy (HT) for the management of early surgical menopause. The PDA development was guided by the Ottawa Decision Support Framework and the International Patient Decision Aid Standards and involved three phases: an exploratory phase to identify women's decisional needs; a development phase to identify evidence related to treatment options and draft initial prototype; and an evaluation phase to evaluate the prototype and elicit views on acceptability in women (N = 12). All phases were driven by a multidisciplinary group of researchers, clinicians, and patient stakeholders to ensure women's priorities were met. A prototype PDA was drafted based on needs identified from the exploratory phase. The PDA has five domains: information on surgical menopause and HT; HT outcome probabilities; patient stories; values clarification; and guidance in deliberation. Participants in the evaluation phase perceived the tool as acceptable and offered suggestions for modifications. Through our adopted, systematic approach the SheEmpowers PDA was developed to help women overcome deterrents to decision-making related to lack of knowledge, decision-making skills, and involvement in therapy decisions. The decisional effectiveness of the tool is to be assessed in future studies.

Envisioning a future: Values clarification in early recovery from opioid use disorder

High rates of relapse and overdose during early recovery from opioid use disorder (OUD) highlight the importance of providing effective treatment during this crucial phase. While early treatment often focuses on managing urges and withdrawal symptoms, eliciting personally salient motivators may help to target predictors of treatment outcomes such as motivation and self-efficacy. This experimental study examined the effect of a brief values clarification exercise on motivation and self-efficacy for abstinence in a sample of n = 93 individuals in brief residential treatment for OUD. Participants were randomly assigned to values clarification or a time management control condition exercise. Self-efficacy for abstinence as measured by a validated single-item measure was higher for participants in the values condition (M = 8.7) compared to control (M = 7.8, p = .013), while motivation for abstinence as measured by the commitment to sobriety scale was similarly high for both the values clarification (M = 28.0) and control (M = 27.8, p = .642) groups. There were no group differences in delay discounting, the theorized mediator of these relationships. Taken together, these results suggest that even a brief values clarification exercise may increase self-efficacy for abstinence when added to early residential treatment for OUD.

Strengthening the Religious Moderation through Innovation of Islamic Religious Education (IRE) based Civic Intelligence and the Values Clarification Technique (VCT)

In Indonesia, the dissemination of religious radicalism not only occurs in educational institutions but has also spread into other social institutions. In the scope of higher education, the National Counter Terrorism Agency (BNPT) released the results of their research in 2018, indicate the emergence of radicalism in several state universities. Although several other parties questioned the details of BNPT’s findings, the research made “politics of fear” after explicitly labelling seven well-known state universities exposed to radical ideology. This research is directed to formulate the learning innovation on Islamic Religious Education (IRE) based Civic Intelligence using the Values Clarification Technique (VCT) learning model as an effort to strengthen religious moderation. This research is classified into the research and development (R&D) model which conducted at State University of Malang (UM) and the development model used the ADDIE model. The result revealed that the mapping for religious moderation after getting treatment can be grouped into five categories (very high: 9.97%, high: 9.30%, moderate: 51.82%, low: 26.57% and very low: 2.32%).
 Keywords: Civic Intelligence, Moderation, Islamic Religious Education

A review of stress management interventions for the oncology nursing workforce: What do we know and what should we be doing differently?

Oncology nurses are at risk of chronic stress. In this narrative review we provide an overview of stress man-agement intervention studies for oncology nurses, and suggest that Acceptance and Commitment Thera-py/Training (ACT) provides a better intervention framework due to the relevance of underpinning therapeutic processes (e.g. acceptance, mindfulness, values clarification) to the role and stress-related experiences of this workforce population. Current evidence for the effectiveness of stress management intervention varies, with few studies describing how theory informs intervention content, or justifying why they should benefit this popu-lation specifically. ACT lends itself to data-driven intervention development, thus potentially addressing some methodological limitations in this field. Only one trial has tested ACT in this population, reporting only partial effects. Further empirical research is required given (a) the applicability of ACT for this population and context, and (b) the associated advantages of brief and/or group delivery to address known barriers to participating in stress management interventions.

PERANAN MODEL PEMBELAJARAN VALUE CLARIFICATION TECHNIQUE BERBANTUAN MEDIA AUDIO VISUAL PADA PEMBELAJARAN IPS ERA MILENIAL

To fulfill education in the current millenial generation, educators always make interesting innovations that can make students’ interests increase. The development of teaching concepts by applying learning principles, models and interactive media to social studies learning continues. The application of social values in the Value Clarification Technique (VCT) learning model through the help of audio visual media into social studies lessons, students can instiil social values individually as well as learning experiences for real life provision. In addition, students not only have cognitive aspects, but also have adventages in the affective aspects which are certainly needed in the millenial era.

PERANAN MODEL PEMBELAJARAN VALUE CLARIFICATION TECHNIQUE BERBANTUAN MEDIA AUDIO VISUAL PADA PEMBELAJARAN IPS ERA MILENIAL

To fulfill education in the current millenial generation, educators always make interesting innovations that can make students’ interests increase. The development of teaching concepts by applying learning principles, models and interactive media to social studies learning continues. The application of social values in the Value Clarification Technique (VCT) learning model through the help of audio visual media into social studies lessons, students can instiil social values individually as well as learning experiences for real life provision. In addition, students not only have cognitive aspects, but also have adventages in the affective aspects which are certainly needed in the millenial era.

A decision aid to facilitate informed choices among cataract patients: A randomized controlled trial

ObjectiveTo assess the effect of a patient decision aid on the quality of decision-making for patients with age-related cataracts. Methods773 patients with cataracts aged 50–80 years were randomly assigned to receive either the intervention decision aid (including standard information, quantitative information on the possible outcomes of cataract surgery and a value clarification exercise) or the control booklet (including standard information). The primary outcome was informed choice (defined as adequate knowledge and congruency between attitudes and surgical intentions), which was assessed at 2 weeks after intervention via a telephone interview. ResultsThe decision aid increased the proportion of participants making an informed choice, from 5.68 % in the control group to 27.7 % in the intervention group (P < 0.001). Compared with controls, more participants in the intervention group had adequate overall knowledge about cataract surgery (36.8 % vs. 8.79 % in controls; P < 0.001), and fewer participants intended to undergo surgery (22.5 % vs. 34.1 % in controls; P < 0.001). ConclusionUse of the patient decision aid may increase the proportion of patients making informed choices. Importantly, it might also reduce the acceptance of operations.Practice implications: Patient decision aids represent a simple and low-cost tool to facilitate informed choice among patients with cataracts.

A decision aid for additional findings in genomic sequencing: Development and pilot testing

ObjectiveTo describe the development of a web-based, patient-facing decision aid to support patients and research participants to make an informed, values-based decision about whether to receive additional results from genomic sequencing. MethodsWe developed the decision aid following the multi-step process described in the International Patient Decision Aids Standards. This utilized literature review, focus groups, and alpha testing with research participants undergoing clinical genomic sequencing. ResultsThe decision aid, the Optional Results Choice Aid (ORCA), includes a seven-question “values clarification exercise,” illustrative patient quotes, and summative guidance for the user. The decision aid was found to be highly readable, acceptable and relevant in alpha testing. ConclusionWe developed a decision aid to support informed, values-based decision making for patients and research participants considering whether to receive additional results from genomic sequencing. ORCA is being implemented in the NHGRI-funded Cancer Health Assessment Reaching Many (CHARM) study, where we are measuring informed values-choice congruence. Practice implicationsORCA was designed to support patients and research participants to make an informed, values-based decision about whether to receive additional results from genomic sequencing.

Effect of a Prostate Cancer Screening Decision Aid for African-American Men in Primary Care Settings.

African-American men have an elevated risk of developing and dying from prostate cancer. Shared decision-making (SDM) about prostate cancer screening is recommended but does not always occur. We pilot-tested an online decision aid (DA) in primary care settings using a pre/postevaluation design among African-American men ages 45 to 70 years. Men completed surveys before and after using the DA, which had interactive segments (e.g., values clarification) and provided individualized assessment of prostate cancer risk. Primary outcomes included prostate cancer knowledge, confidence in ability to make informed decisions, decisional conflict, and satisfaction with the decision. Immediately after the clinical visit, patients reported the degree to which they were engaged by their provider in SDM. Among this sample of men (n = 49), use of the DA was associated with increased knowledge about prostate cancer [mean = 55.3% vs. 71.2%; 95% confidence interval (CI), 9.8-22.1; P < 0.001], reduced decisional conflict (mean = 33.4 vs. 23.6; 95% CI, -18.1 to -1.6; P = 0.002) on a scale from 0 to 100, and a decreased preference to be screened (88% vs. 69%; 95% CI, 0.09-0.64; P = 0.01). Most (89%) reported that the DA prepared them well/very well for SDM with their provider. Following the clinical visit with providers, scores on perceived involvement in SDM were 68.1 (SD 29.1) on a 0 to 100 scale. The DA improved men's knowledge, reduced decisional conflict, and promoted the perception of being prepared for SDM. Findings suggest that use of an online DA to improve SDM outcomes warrants further testing in a future trial.

DEVELOPMENT OF VALUE CLARIFICATION TECHNIQUE LEARNING MODELS BASED ROLE-PLAYING GAME TO INCREASE INTERNALIZATION OF STUDENT CHARACTER VALUES

The Era of Industrial Revolution 4.0 has an impact on the young generation, especially, on attitudes and character changes. In this case, we felt that the implementation of education about values, attitudes, and character in the educational institutions, eitherformaland non-formal education, especially primary education, was very important, and urged to increase its intensity and quality. This research aimed to develop a learning model in the form of a value clarification technique (VCT) based on a role-playing game for improving the value of internalization in the students. The research method used is research and development (R &amp; D). The research subjects were the elementary students of grade V in the Bengkulu Municipality. Data collection was carried out by using attitude observation sheets. Based on the results of the study, it can be concluded that (1) internalization of student character values can be improved through the development of an integrated learning model between technique and games value clarification. (b)the application of learning models by integrating value clarification technique and game was very effective to improve the internalization of character values into students.

Development and validation of a psychometric scale to assess attitude towards safe abortions in Pakistan

Despite severe health and economic consequences that women face because of the negative attitude of healthcare providers towards safe abortion and post-abortion care (SA/PAC), no psychometric tool has yet been validated for assessing the attitude towards SA/PAC. Only a handful of studies have attempted to assess healthcare providers' attitude towards safe abortions in Pakistan. Therefore, this study aimed to develop and validate a psychometric scale to assess attitude towards safe abortions in Pakistan. The study collected data from 106 workers of an NGO that provides SA/PAC through an online and anonymous survey using the organisation's network. The study used factor analytic techniques and structural equation modelling to validate the factor structure and a final hierarchical model. A final scale of seven items relating to attitude towards elective abortions and moral attitude towards safe abortions was validated. The scales were highly reliable with both factors having reliability indicators greater than 0.7. The scale can be easily implemented to assess providers' attitude towards safe abortions. This will allow programmers to screen healthcare providers with a negative attitude, and evaluate the efficacy of their Value Clarification and Attitude Transformation (VCAT) programmes that are aimed at transforming providers' attitude towards safe abortions.