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Patient Educ Couns. 2016 Feb;99(2):236-42. doi: 10.1016/j.pec.2015.08.025. Epub 2015 Aug 24.

Using Option Grids: steps toward shared decision-making for neonatal circumcision.

Author information

1
Dartmouth Hitchcock Medical Center, Lebanon, USA; Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, USA. Electronic address: Mary.E.Fay@hitchcock.org.
2
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: Stuart.S.W.Grande@dartmouth.edu.
3
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: Kyla.Z.Donnelly.GR@dartmouth.edu.
4
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: glynelwyn@gmail.com.

Abstract

OBJECTIVES:

To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement.

METHODS:

We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention.

RESULTS:

Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process.

CONCLUSIONS:

Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making.

PRACTICE IMPLICATIONS:

Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice.

KEYWORDS:

Circumcision; Communication; Encounter tools; Informed consent; Patient decision aids; Patient engagement; Shared decision-making

PMID:
26324111
DOI:
10.1016/j.pec.2015.08.025
[Indexed for MEDLINE]

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