Clinician feedback using a shared decision-making tool for the evaluation of patients with thyroid nodules—an observational study,Endocrine

当前位置： X-MOL 学术 › Endocrine › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Clinician feedback using a shared decision-making tool for the evaluation of patients with thyroid nodules—an observational study
Endocrine ( IF 3.0 ) Pub Date : 2023-09-11 , DOI: 10.1007/s12020-023-03519-z
Naykky Singh Ospina ₁ , Chandani Patel Chavez ₁ , Eddison Godinez Leiva ₁ , Diliara Bagautdinova ₂ , Jessica Hidalgo ₃ , Sandra Hartasanchez ₃ , Sandra Algarin Perneth ₃ , Diana Barb ₁ , Deepa Danan ₄ , Peter Dziegielewski ₄ , Brian Hughley ₄ , Ashok Srihari ₁ , Sreevidya Subbarayan ₁ , M Regina Castro ₅ , Diana Dean ₅ , John Morris ₅ , Mabel Ryder ₅ , Marius N Stan ₅ , Ian Hargraves ₃ , Carma L Bylund ₆ , Debbie Treise ₂ , Victor M Montori _{3,

5} , Juan P Brito _{3,

5}

Affiliation

Background

We pilot-tested an encounter conversation aid to support shared decision making (SDM) between patients with thyroid nodules and their clinicians.

Objective

Characterize the clinician feedback after providing care to patients with thyroid nodules using a tool to promote SDM conversations during the clinical encounter, and evaluate how clinicians used the tool during the visit.

Methods

Mixed method study in two academic centers in the U.S., including adult patients presenting for evaluation of thyroid nodules and their clinicians. We thematically analyzed interviews with clinicians after they used the SDM tool in at least three visits to characterize their feedback. Additionally, investigators evaluated visits recordings to determine the extent to which clinicians engaged patients in the decision-making process (OPTION score, scale 0 to 100, higher levels indicating higher involvement), the tool’s components used (fidelity), and encounter duration. Using a post-visit survey, we evaluated the extent to which clinicians felt the tool was easy to use, helpful, and supportive of the patient-clinician collaboration.

Results

Thirteen clinicians participated in the study and used the SDM tool in the care of 53 patients. Clinicians thought the tool was well-organized and beneficial to patients and clinicians. Clinicians noticed a change in their routine with the use of the conversation aid and suggested it needed to be more flexible to better support varying conversations. The median OPTION score was 34, the fidelity of use 75%, and the median visit duration 17 min. In most encounters, clinicians agreed or strongly agreed the tool was easy to use (86%), helpful (65%), and supported collaboration (62%).

Conclusion

Clinicians were able to use a SDM tool in the care of patients with thyroid nodules. Although they wished it were more flexible, they found on the whole that its use in the clinical encounter was beneficial to patients and clinicians.

中文翻译：

使用共享决策工具评估甲状腺结节患者的临床医生反馈——一项观察性研究

背景

我们对一种相遇对话辅助工具进行了试点测试，以支持甲状腺结节患者与其临床医生之间的共同决策 (SDM)。

客观的

描述临床医生在临床就诊期间使用促进 SDM 对话的工具为甲状腺结节患者提供护理后的反馈，并评估临床医生在就诊期间如何使用该工具。

方法

在美国两个学术中心进行的混合方法研究，包括接受甲状腺结节评估的成年患者及其临床医生。我们对临床医生在至少三次使用 SDM 工具后的访谈进行了主题分析，以描述他们的反馈。此外，研究人员还评估了就诊记录，以确定临床医生让患者参与决策过程的程度（选项评分，范围从 0 到 100，级别越高表明参与程度越高）、所使用的工具组件（保真度）以及就诊持续时间。通过访问后调查，我们评估了临床医生认为该工具易于使用、有帮助以及支持患者与临床医生合作的程度。

结果

13 名临床医生参与了这项研究，并使用 SDM 工具治疗了 53 名患者。临床医生认为该工具组织良好，对患者和临床医生都有好处。临床医生注意到使用对话辅助工具后他们的日常生活发生了变化，并建议它需要更加灵活，以更好地支持不同的对话。 OPTION 评分中位数为 34，使用保真度为 75%，访问持续时间中位数为 17 分钟。在大多数情况下，临床医生都同意或强烈同意该工具易于使用（86%）、有帮助（65%）并且支持协作（62%）。