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The Impact of Explicit Values Clarification Exercises in a Patient Decision Aid Emerges After the Decision Is Actually Made

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Listed:
  • Deb Feldman-Stewart
  • Christine Tong
  • Rob Siemens
  • Shabbir Alibhai
  • Tom Pickles
  • John Robinson
  • Michael D. Brundage

Abstract

Purpose To determine if particular values clarification exercises included in a patient decision aid had discernible impact on postdecisional regret in patients with early-stage prostate cancer. Methods A multicenter randomized controlled trial compared 2 versions of a computerized patient decision aid: only structured information compared to the structured information plus values clarification exercises. Assessments were conducted during the decision aid visit; telephone follow-up interviews were conducted when patients made their decisions with their physician, 3 months after completing treatment, and >1 year later (per a mailing). Outcome measures included the Decisional Conflict Scale, the Preparation for Decision Making Scale, and the Decision Regret Scale. Results A total of 156 patients participated, 75 provided information only and 81 provided information plus values clarification exercises. The groups did not differ significantly on any outcome evaluated at the decision aid visit; in both groups, decisional conflict decreased immediately after using the decision aid. Between-group differences emerged after the decision was actually made. The values clarification exercises group reported higher Preparation for Decision Making Scale scores at the decision follow-up and at the >1-year follow-up. Regret did not differ significantly between groups at the 3-month follow-up but was lower for the values clarification exercises group than for the information group at the >1-year follow-up. Conclusion The results suggest that the values clarification exercises led to better preparation for decision making and to less regret. The impact, however, only emerged after the decision was made.

Suggested Citation

  • Deb Feldman-Stewart & Christine Tong & Rob Siemens & Shabbir Alibhai & Tom Pickles & John Robinson & Michael D. Brundage, 2012. "The Impact of Explicit Values Clarification Exercises in a Patient Decision Aid Emerges After the Decision Is Actually Made," Medical Decision Making, , vol. 32(4), pages 616-626, July.
    • Handle: RePEc:sae:medema:v:32:y:2012:i:4:p:616-626
    DOI: 10.1177/0272989X11434601
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    References listed on IDEAS

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    1. Loomes, Graham & Sugden, Robert, 1982. "Regret Theory: An Alternative Theory of Rational Choice under Uncertainty," Economic Journal, Royal Economic Society, vol. 92(368), pages 805-824, December.
    2. repec:cup:judgdm:v:4:y:2009:i:2:p:141-146 is not listed on IDEAS
    3. Reb, Jochen, 2008. "Regret aversion and decision process quality: Effects of regret salience on decision process carefulness," Organizational Behavior and Human Decision Processes, Elsevier, vol. 105(2), pages 169-182, March.
    4. Loomes, Graham & Sugden, Robert, 1987. "Some implications of a more general form of regret theory," Journal of Economic Theory, Elsevier, vol. 41(2), pages 270-287, April.
    5. Svenson, Ola & Benthorn, Lars J., 1992. "Consolidation processes in decision making: Post-decision changes in attractiveness of alternatives," Journal of Economic Psychology, Elsevier, vol. 13(2), pages 315-327, June.
    6. David E. Bell, 1982. "Regret in Decision Making under Uncertainty," Operations Research, INFORMS, vol. 30(5), pages 961-981, October.
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    Cited by:

    1. Pieterse, Arwen H. & de Vries, Marieke & Kunneman, Marleen & Stiggelbout, Anne M. & Feldman-Stewart, Deb, 2013. "Theory-informed design of values clarification methods: A cognitive psychological perspective on patient health-related decision making," Social Science & Medicine, Elsevier, vol. 77(C), pages 156-163.
    2. Holly O. Witteman & Ruth Ndjaboue & Gratianne Vaisson & Selma Chipenda Dansokho & Bob Arnold & John F. P. Bridges & Sandrine Comeau & Angela Fagerlin & Teresa Gavaruzzi & Melina Marcoux & Arwen Pieter, 2021. "Clarifying Values: An Updated and Expanded Systematic Review and Meta-Analysis," Medical Decision Making, , vol. 41(7), pages 801-820, October.

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