Patient Priorities Aligned Discrete Decision Making for Older Adults With Multiple Chronic Conditions.

无干预：控制臂

实验性的：AI Chatbot

行为的：AI Chatbot

Participants receive a personalized web link by email .The link provides access to the Priorities AI chatbot on any internet-connected device. The chatbot guides participants through a structured conversation to identify their health priorities and goals related to their surgical decision,

Decision regret as assessed by the Decision regret scale

This is a 5 item questionnaire and each is scored from 0(no regret)-5 (high regret). Average of the item scores are calculated then 1 is subtracted and the final score is multiplied by 25 for a final metric from 0 to 100. Higher scores indicating worse outcome

Self-identified health goals following elective hernia surgery, as measured by the Goal Attainment Scale (GAS)

This is rated on a 5-point scale from -2 (much less than expected) to +2 (much better than expected), with 0 representing the expected level of goal attainment. Higher scores indicate greater attainment of individualized goals.

Decision-making quality in surgical consultations using the Shared Decision-Making Process (SDMP)Scale

The Shared Decision-Making Process (SDMP) Scale is a 4-item, patient-reported measure. Maximum scores range from 0 to 4, with higher scores indicating greater shared decision-making.

Perceived involvement in care using the Perceived Involvement in Care Scale (PICS, binary format)

This is a 13 item questionnaire and each is scored as 1(agree) or 0(disagree) for a total score 0-13, with higher scores indicating greater perceived involvement in care.

Decisional confidence using the SURE scale

This is a 4 item questionnaire and each is scored as a 1(yes) or 0(no) for a maximum score of 0-4,higher score indicating greater decisional confidence

Acceptability as assessed by the Acceptability of Intervention Measure (AIM)

This is a 4 item questionnaire and each is scored on a 5-point Likert scale from 1( completely disagree) to 5 (completely agree) for a maximum score of 4-20, higher scores indicate greater perceived acceptability

Appropriateness as assessed by the Intervention Appropriateness Measure (IAM)

This is a 4 item questionnaire and each is scored on a 5-point Likert scale from 1( completely disagree) to 5 (completely agree) for a maximum score of 4-20, higher scores indicate greater perceived appropriateness

Feasibility as assessed by the Feasibility of Intervention Measure (FIM)

This is a 4 item questionnaire and each is scored on a 5-point Likert scale from 1( completely disagree) to 5 (completely agree) for a maximum score of 4-20, higher scores indicate greater perceived feasibility

Assigned preparation approach on health-related quality of life using the Short Form (SF-12) Quality of Life Scale

The SF-12 assesses physical and mental health across eight health concepts and generates two summary scores: the Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12). Both scores are calculated using responses to all 12 items and are typically reported on a 0-100 scale, with higher scores indicating better health-related quality of life.

Comfort and function following surgery using the Carolina's Comfort Scale (CCS)

This is a 23 item questionnaire and each is scored from 0(no symptoms) to 5( disabling symptoms) for a score range of 0-115, higher score indicating worse postoperative comfort

Satisfaction as assessed by the Satisfaction Measure

This is a 1 item questionnaire and scored from 0(worst visit possible)-10 ( best visit possible) , higher value means better outcome