Decisional Conflict Scale Findings among Patients and Surrogates Making Health Decisions: Part II of an Anniversary Review

Mirjam M. Garvelink, Laura Boland, Krystal Klein, Don Vu Nguyen, Matthew Menear, Hilary L. Bekker, Karen B. Eden, Annie LeBlanc, Annette M. O’Connor, Dawn Stacey and France Légaré
Additional contact information
Mirjam M. Garvelink: Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada
Laura Boland: Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada
Krystal Klein: Cambia Health Solutions, Portland, OR, USA
Don Vu Nguyen: Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada
Matthew Menear: Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada
Hilary L. Bekker: Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
Karen B. Eden: Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University (OHSU) Department of Medical Informatics & Clinical Epidemiology, Portland, OR, USA
Annie LeBlanc: Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada
Annette M. O’Connor: Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada
Dawn Stacey: Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada
France Légaré: Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada

Medical Decision Making, 2019, vol. 39, issue 4, 316-327

Abstract: Background. We explored decisional conflict as measured with the 16-item Decisional Conflict Scale (DCS) and how it varies across clinical situations, decision types, and exposure to decision support interventions (DESIs). Methods. An exhaustive scoping review was conducted using backward citation searches and keyword searches. Eligible studies were published between 1995 and March 2015, used an original experimental/observational research design, concerned a health-related decision, and provided DCS data. Dyads independently screened titles/abstracts and full texts, and extracted data. We performed narrative syntheses and calculated average or median DCS scores. Results. We included 246 articles reporting on 253 studies. DCS scores ranged from 2.4 to 79.7 out of 100. Highest baseline DCS scores were for care planning (44.8 ± 8.9, median = 47.0) and treatment decisions (32.5 ± 12.6, median = 31.9), in contexts of primary care (40.6 ± 18.3), and geriatrics (39.8 ± 11.2). Baseline scores were high among decision makers who were ill (33.2 ± 14.1, median = 30.2) or making decisions for themselves (33.4 ± 13.8, median = 32.0). Total DCS scores 37.4). After DESI use, DCS scores decreased short-term but increased or remained the same long-term (>6 months). Conclusions. DCS scores were highest at baseline and decreased after decision making. DESIs decreased decisional conflict immediately after decision making. The largest improvements after DESIs were in decision makers who were ill or made decisions for themselves. Further meta-analyses are needed for decision type, contexts, and interventions to inform hypotheses about the expected effects of DESIs, the best timing for measurement, and interpretation of DCS scores.

Keywords: Shared Decision Making; Decisional Conflict Scale; decisional conflict; measurement; scoping review (search for similar items in EconPapers)
Date: 2019
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Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:4:p:316-327

DOI: 10.1177/0272989X19851346

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