Decision aid tools to support women's decision making in pregnancy and birth: A systematic review and meta-analysis

被引:101
作者
Dugas, Marylene [1 ,2 ]
Shorten, Allison [3 ]
Dube, Eric [2 ]
Wassef, Maggy [2 ]
Bujold, Emmanuel [4 ]
Chaillet, Nils [1 ,2 ]
机构
[1] Univ Montreal, Dept Obstet & Gynecol, Fac Med, Montreal, PQ H3T 1C5, Canada
[2] Univ Montreal, Ste Justine Hosp Res Ctr, Montreal, PQ, Canada
[3] Yale Univ, Yale Sch Nursing, Grad Nursing Programs, New Haven, CT USA
[4] Univ Laval, Fac Med, Dept Obstet & Gynaecol, Quebec City, PQ G1K 7P4, Canada
关键词
Obstetrics; Doctor-patient relations; Decision support techniques; Directive counseling; Health education; Informed consent; Decision making; Patient-centered care; RANDOMIZED CONTROLLED-TRIAL; PREVIOUS CESAREAN-SECTION; VAGINAL BIRTH; IMPLEMENTING GUIDELINES; PRENATAL-DIAGNOSIS; HEALTH-CARE; INFORMATION; PATIENT; LEAFLET; CHOICE;
D O I
10.1016/j.socscimed.2012.01.041
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Support for a model of shared medical decision making, where women and their care providers discuss risks and benefits of their different options, reveal their preferences, and jointly make a decision, is a growing expectation in obstetric care. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of different decision aid tools compared to regular care for women facing several options in the specific field of obstetric care. We included published studies about interventions designed to aid mothers' decision making and provide information about obstetrical treatment or screening options. Following a search of electronic databases for articles published in English and French from 1994 to 2010, we found ten studies that met the inclusion criteria. In this systematic review and meta-analysis we found that all decision aid tools, except for Decision Trees, facilitated significant increases in knowledge. The Computer-based Information Tool, the Decision Analysis Tools, Individual Counseling and Group Counseling intervention presented significant results in reducing anxiety levels. The Decision Analysis Tools and the Computer-based Information tool were associated with a reduction in levels of decisional conflict. The Decision Analysis Tool was the only tool that presented evidence of an impact on the final choice and final outcome. Decision aid tools can assist health professionals to provide information and counseling about choices during pregnancy and support women in shared decision making. The choice of a specific tool should depend on resources available to support their use as well as the specific decisions being faced by women, their health care setting and providers. (C) 2012 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1968 / 1978
页数:11
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