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Decisional Conflict Scale Findings among Patients and Surrogates Making Health Decisions: Part II of an Anniversary Review

Author

Listed:
  • Mirjam M. Garvelink

    (Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada)

  • Laura Boland

    (Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada)

  • Krystal Klein

    (Cambia Health Solutions, Portland, OR, USA)

  • Don Vu Nguyen

    (Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada)

  • Matthew Menear

    (Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada
    Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada)

  • Hilary L. Bekker

    (Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK)

  • Karen B. Eden

    (Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University (OHSU) Department of Medical Informatics & Clinical Epidemiology, Portland, OR, USA)

  • Annie LeBlanc

    (Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada)

  • Annette M. O’Connor

    (Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada)

  • Dawn Stacey

    (Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada
    Ottawa Hospital Research Institute, Ottawa, ON, Canada)

  • France Légaré

    (Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada
    Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada)

Abstract

Background. We explored decisional conflict as measured with the 16-item Decisional Conflict Scale (DCS) and how it varies across clinical situations, decision types, and exposure to decision support interventions (DESIs). Methods. An exhaustive scoping review was conducted using backward citation searches and keyword searches. Eligible studies were published between 1995 and March 2015, used an original experimental/observational research design, concerned a health-related decision, and provided DCS data. Dyads independently screened titles/abstracts and full texts, and extracted data. We performed narrative syntheses and calculated average or median DCS scores. Results. We included 246 articles reporting on 253 studies. DCS scores ranged from 2.4 to 79.7 out of 100. Highest baseline DCS scores were for care planning (44.8 ± 8.9, median = 47.0) and treatment decisions (32.5 ± 12.6, median = 31.9), in contexts of primary care (40.6 ± 18.3), and geriatrics (39.8 ± 11.2). Baseline scores were high among decision makers who were ill (33.2 ± 14.1, median = 30.2) or making decisions for themselves (33.4 ± 13.8, median = 32.0). Total DCS scores 37.4). After DESI use, DCS scores decreased short-term but increased or remained the same long-term (>6 months). Conclusions. DCS scores were highest at baseline and decreased after decision making. DESIs decreased decisional conflict immediately after decision making. The largest improvements after DESIs were in decision makers who were ill or made decisions for themselves. Further meta-analyses are needed for decision type, contexts, and interventions to inform hypotheses about the expected effects of DESIs, the best timing for measurement, and interpretation of DCS scores.

Suggested Citation

  • Mirjam M. Garvelink & Laura Boland & Krystal Klein & Don Vu Nguyen & Matthew Menear & Hilary L. Bekker & Karen B. Eden & Annie LeBlanc & Annette M. O’Connor & Dawn Stacey & France Légaré, 2019. "Decisional Conflict Scale Findings among Patients and Surrogates Making Health Decisions: Part II of an Anniversary Review," Medical Decision Making, , vol. 39(4), pages 316-327, May.
  • Handle: RePEc:sae:medema:v:39:y:2019:i:4:p:316-327
    DOI: 10.1177/0272989X19851346
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    References listed on IDEAS

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    1. Mirjam M. Garvelink & Laura Boland & Krystal Klein & Don Vu Nguyen & Matthew Menear & Hilary L. Bekker & Karen B. Eden & Annie LeBlanc & Annette M. O’Connor & Dawn Stacey & France Légaré, 2019. "Decisional Conflict Scale Use over 20 Years: The Anniversary Review," Medical Decision Making, , vol. 39(4), pages 301-314, May.
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    Cited by:

    1. Lauren Hoefel & Krystina B Lewis & Annette O’Connor & Dawn Stacey, 2020. "20th Anniversary Update of the Ottawa Decision Support Framework: Part 2 Subanalysis of a Systematic Review of Patient Decision Aids," Medical Decision Making, , vol. 40(4), pages 522-539, May.
    2. Yulia Gendler & Ayala Blau, 2024. "Exploring Cultural and Religious Effects on HPV Vaccination Decision Making Using a Web-Based Decision Aid: A Quasi-experimental Study," Medical Decision Making, , vol. 44(4), pages 426-436, May.

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