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More primary care patients regret health decisions if they experienced decisional conflict in the consultation: a secondary analysis of a multicenter descriptive study

机译:如果更多的初级保健患者在咨询中遇到决策冲突,他们会后悔健康决策:一项多中心描述性研究的二级分析

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Background We sought to estimate the extent of decision regret among primary care patients and identify risk factors associated with regret. Methods Secondary analysis of an observational descriptive study conducted in two Canadian provinces. Unique patient-physician dyads were recruited from 17 primary care clinics and data on patient, physician and consultation characteristics were collected before, during and immediately after consultations, as well as two weeks post-consultation, when patients completed the Decision Regret Scale (DRS). We examined the DRS score distribution and performed ordinal logistic regression analysis to identify predictors of regret. Results Among 258 unique patient-physicians dyads, mean?±?standard deviation of decision regret scores was 11.7?±?15.1 out of 100. Overall, 43?% of patients reported no regret, 45?% reported mild regret and 12?% reported moderate to strong regret. In multivariate analyses, higher decision regret was strongly associated with increased decisional conflict and less significantly associated with patient age and education, as well with male (vs. female) physicians and residents (vs. teachers). Conclusion After consulting family physicians, most primary care patients experience little decision regret, but some experience more regret if there is decisional conflict. Strategies for reducing decisional conflict in primary care, such as shared decision-making with decision aids, seem warranted.
机译:背景我们试图估计初级保健患者中决策后悔的程度,并确定与后悔相关的危险因素。方法在加拿大两个省进行的一项观察性描述性研究的二级分析。当患者完成决策后悔量表(DRS)时,从17家初级保健诊所招募了独特的患者-医师双元征,并在咨询之前,咨询期间和咨询之后以及咨询之后的两周收集了有关患者,医师和咨询特征的数据。 。我们检查了DRS分数分布并进行了序数逻辑回归分析,以找出后悔的预测因素。结果在258位独特的医师-医师双联中,决策后悔评分的平均标准偏差为11.7分±15.1(满分100分)。总体而言,有43%的患者报告不感到遗憾,有45%的患者报告有轻度遗憾,有12 %%。报告中度到强烈的遗憾。在多变量分析中,较高的决策后悔与决策冲突的增加密切相关,而与患者的年龄和受教育程度以及男性(对女性)医生和住院医师(对教师)的相关性不那么明显。结论在咨询了家庭医生之后,大多数初级保健患者的决策后悔很少,但如果存在决策冲突,则有些后悔更大。似乎有必要采取措施减少初级保健中的决策冲突,例如通过决策辅助手段共同制定决策。

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