More primary care patients regret health decisions if they experienced decisional conflict in the consultation: a secondary analysis of a multicenter descriptive study

被引:46
作者
Becerra-Perez, Maria-Margarita [1 ]
Menear, Matthew [1 ]
Turcotte, Stephane [1 ]
Labrecque, Michel [1 ,2 ]
Legare, France [1 ,2 ]
机构
[1] Univ Laval, St Francois Assise Hosp, CHU Quebec Res Ctr, 10 Espinay, Quebec City, PQ G1L 3L5, Canada
[2] Univ Laval, Fac Med, Dept Family Med & Emergency Med, 1050 Ave Ferdinard Vandry, Quebec City, PQ G1V 0A6, Canada
关键词
Decision regret; Decisional conflict; Shared decision-making; Primary care; Dyads; Risk factors; ACUTE RESPIRATORY-INFECTIONS; TRAINING FAMILY PHYSICIANS; OPTION SCALE; VALIDATION; GENDER; COMMUNICATION; SATISFACTION; ANTIBIOTICS; INVOLVEMENT; BEHAVIOR;
D O I
10.1186/s12875-016-0558-0
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: We sought to estimate the extent of decision regret among primary care patients and identify risk factors associated with regret. Methods: Secondary analysis of an observational descriptive study conducted in two Canadian provinces. Unique patient-physician dyads were recruited from 17 primary care clinics and data on patient, physician and consultation characteristics were collected before, during and immediately after consultations, as well as two weeks post-consultation, when patients completed the Decision Regret Scale (DRS). We examined the DRS score distribution and performed ordinal logistic regression analysis to identify predictors of regret. Results: Among 258 unique patient-physicians dyads, mean +/- standard deviation of decision regret scores was 11.7 +/- 15.1 out of 100. Overall, 43 % of patients reported no regret, 45 % reported mild regret and 12 % reported moderate to strong regret. In multivariate analyses, higher decision regret was strongly associated with increased decisional conflict and less significantly associated with patient age and education, as well with male (vs. female) physicians and residents (vs. teachers). Conclusion: After consulting family physicians, most primary care patients experience little decision regret, but some experience more regret if there is decisional conflict. Strategies for reducing decisional conflict in primary care, such as shared decision-making with decision aids, seem warranted.
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页码:1 / 11
页数:11
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