Impact of Decision Quality by Using Question Prompt List
1 août 2021 mis à jour par: National Taiwan University Hospital
Impact of Decision Quality by Using Question Prompt List on the Shared Decision Making in End-stage Renal Disease Patients
To investigate the effects of a question prompt list (QPL) on a shared decision-making consultation among facing decision for dialysis in end-stage renal disease (ESRD) patients.
A randomized controlled trial was conducted at the university medical center of North Taiwan.
Subjects were randomized assigned to QPL group or usual care group.
Decisional quality and decision control preferences were assessed with questionnaires.
Measurements were performed at before the counseling (T0), immediately after counseling (T1), and evaluate decision regret at one month after treatment.
Aperçu de l'étude
Statut
Inscription sur invitation
Les conditions
Intervention / Traitement
Description détaillée
The aim of this study was to investigate the effectiveness of decisional quality and decisional control preferences by using a specific question prompt list (QPL) during a shared decision-making consultation among facing decision for dialysis in end-stage renal disease (ESRD) patients.
A randomized controlled trial was conducted at the university medical center of North Taiwan.
Recruit subjects are those who are about to receive the nurse-led coaching of shared decision-making (SDM) for patients with ESRD and attend the program.
By using blocked Randomization design, the investigators assigned participants to QPL group or usual care.
Prior to a clinic visit to discuss treatment, two-pages ESRD QPL leaflets are provided to QPL group, while usual care group without receiving provision of QPL.
Measurements of outcome included decision quality (decision conflict, decisional self-efficiency) and decision control preference at before the counseling (T0), immediately after counseling (T1), and evaluate decision regret at one month after treatment (T2), at this time the patient has decided and started to accept the selected treatment (hemodialysis, peritoneal dialysis or conservative treatment).
All statistical analyses were performed in SAS statistical software, version 9.4 (SAS, Cary, NC).
The effects of the intervention were assessed by generalized estimating equation (GEE) analysis with the coefficient of interaction ( group × time) term.
Statistical tests were two-sided with a significance level of 0.05.
Hierarchical Linear Model was used to detect the impact of nested within physician.
Type d'étude
Interventionnel
Inscription (Anticipé)
154
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
-
-
Xindian
-
Taipei City, Xindian, Taïwan, 231
- National Taiwan University Hospital
-
-
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
20 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Patients with stage 5 chronic kidney disease who facing decision for dialysis;
- normal cognitive functions;
- be able to read, communicate in Mandarin or Taiwanese;
- ability to express willingness;
Exclusion Criteria:
- vision or hearing function impairment;
- Severe illness;
- Urgent to dialysis for extend life;
- Dialysis modalities Already decided.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Soins de soutien
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: QPL group
receive 2-pages ESRD QPL leaflets, circle the questions they want to ask before consultation.
encourage asking questions with doctor during consultation.
receive the nurse-led coaching of shared decision-making (SDM)
|
The specific QPS was a one page leaflet for chronic kidney disease which developed by applied literature and public QPL from the National Health Agency.
It contains 3 domains 25 questions related to treatment, dialysis, and Kidney transplant.
The QPL group participants were asked to read and mark those questions they concerned or write down additional problems.
|
|
Aucune intervention: Usual care group
without receiving provision of QPL encourage asking questions with doctor during consultation.
receive the nurse-led coaching of shared decision-making (SDM)
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Decision conflict
Délai: before the counseling (T0), immediately after counseling(T1)
|
Decision conflict was measured by Decision conflict scale(DCS).
The scale consists of 16 items into 5 subscales: Uncertainty(3 items), Informed(3 items), values clarity(3 items), support(3 items), and effective decision(4 items) that are rated on a 5-point likert-scale from "strongly agree" (0) to "strongly disagree" (4).
The sum of scores are calculated from 0 to 100.
The higher the score, the higher the level of decision conflict.
|
before the counseling (T0), immediately after counseling(T1)
|
|
Decisional self-efficiency
Délai: before the counseling (T0), immediately after counseling(T1)
|
Decision self-efficiency was measured by Decisional Self-Efficiency Scale(DSES).
The scale represents self-confidence or belief in decision making.
The scale consists of 11 items that are rated on a 5-point likert-scale from "not at all confident" (0) to" very confident "(4) .
The sum of scores are calculated from 0 to 100.
The higher the score, the higher the level of self-confidence.
|
before the counseling (T0), immediately after counseling(T1)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Decision control preference
Délai: one month after treatment (T2)
|
Decision regret was measured by Decision regret Scale(DRS) .The scale consists of 5 items that are rated on a 5-point likert-scale from "strongly agree "(1) to" strongly disagree" (5) .
The sum of scores are calculated from 0 to 100.
The higher the score, the higher the level of regret.
|
one month after treatment (T2)
|
|
Decision control preference
Délai: before the counseling (T0), immediately after counseling(T1)
|
Decision control preference was measured by Decision control preference Scale(DCPS) .The scale asks two question:(1)control preference measured at before the counseling; (2) actual decision control level measured after counseling immediately.
|
before the counseling (T0), immediately after counseling(T1)
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Anticipé)
15 août 2021
Achèvement primaire (Anticipé)
30 juin 2022
Achèvement de l'étude (Anticipé)
31 août 2022
Dates d'inscription aux études
Première soumission
26 juillet 2021
Première soumission répondant aux critères de contrôle qualité
26 juillet 2021
Première publication (Réel)
2 août 2021
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
9 août 2021
Dernière mise à jour soumise répondant aux critères de contrôle qualité
1 août 2021
Dernière vérification
1 mai 2021
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 202104009RINA
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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