Investigating active ingredients in a complex intervention: a nested study within the Patient and Decision Aids PANDAs randomised controlled trial for people with type 2 diabetesReportar como inadecuado




Investigating active ingredients in a complex intervention: a nested study within the Patient and Decision Aids PANDAs randomised controlled trial for people with type 2 diabetes - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Research Notes

, 7:347

First Online: 07 June 2014Received: 23 August 2013Accepted: 28 May 2014DOI: 10.1186-1756-0500-7-347

Cite this article as: Brown, I., Bradley, A., Ng, C.J. et al. BMC Res Notes 2014 7: 347. doi:10.1186-1756-0500-7-347

Abstract

BackgroundRandomised trials provide evidence that patient decision aids improve outcomes with respect to patient knowledge, involvement and satisfaction in decision making. It is less clear how these complex interventions are implemented within patient-clinician interactions and which components are active for improving decision processes. To investigate the experiences of using a diabetes treatment decision aid and to explore how components within a complex intervention influenced the decision making process.

MethodsA pragmatic mixed methods study nested within the PANDAs cluster randomised trial of a patient decision aid. Themes inductively derived from interviews and observation of consultations with further triangulation with results of decision quality and involvement measurements and case analyses.

ResultsThe decision aid intervention was employed flexibly within the consultation with both the patient and clinician active in marshalling elements. The decision aid improved processing and organization of information needed for decision making within the consultation interaction. It also improved decision quality by preparing the patient for active involvement within the clinical consultation.

ConclusionThe intervention was acceptable, flexible and readily implemented in primary care consultations. The decision aid was effective in facilitating cognitive processing. The intervention also facilitated rehearsal in preparation for active roles in a shared decision process.

Trial registrationTrials Register Number: ISRCTN14842077. Date registered: 24.06.2010.

KeywordsPatient decision aid Process evaluation Type 2 diabetes Primary care  Download fulltext PDF



Autor: Ian Brown - Alastair Bradley - Chirk Jenn Ng - Brigitte Colwell - Nigel Mathers

Fuente: https://link.springer.com/







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