Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

The Effect of Shared Decision-making on Decision Self-efficacy and Decisional Conflict of Women with Low-grade Squamous Intraepithelial Lesion in Cervical Cytology: An Experimental Study

Author(s): Saba Baharvand, Mohammad Asghari-Jafarabadi, Roghaiyeh Nourizadeh, Niloufar Sattarzadeh Jahdi, Esmat Mehrabi* and Shiva Shamsdanesh

Volume 20, Issue 5, 2024

Published on: 25 September, 2023

Article ID: e220823220166 Pages: 9

DOI: 10.2174/1573404820666230822111839

Price: $65

conference banner
Abstract

Background: Women often face decisional challenges and hesitation while choosing the appropriate method to follow up on their abnormal results of cervix cytology.

Objective: The present study aimed to determine the effect of shared decision-making (SDM) on decision self-efficacy (DSE) and decisional conflict (DC) about follow-up methods among women with abnormal cervix cytology results.

Methods: This interventional study was performed on 54 women referred to the subspecialty clinic of gynecologic oncology. The women were assigned into intervention and control groups using a randomized block design with block sizes of 4 and 6 and an allocation ratio of 1:1. The intervention group received counseling based on the SDM and a decision aid (DA) booklet. The data collection tools included the questionnaires of the demographic and obstetrics characteristics, DC, DSE, and Decision Regret. The collected data were analyzed using SPSS24 software, and independent t-tests and ANCOVA were used.

Results: After the intervention, the total mean score of the DC in the intervention group was significantly lower than that in the control group [MD: -22.84 with 95% CI: -23.52 to -21.95, (P <0.001)]. The mean score of DSE in the intervention group was significantly higher than that in the control group [MD: 14.56 with 95% CI: 21.47 to 7.65, (P <0.001)].

Conclusion: The present study results indicated that counseling based on the SDM effectively promotes DSE and reduces DC among women with minor abnormal cervical cytology. Therefore, it is recommended that healthcare providers use SDM for women with abnormal cervical cancer screening results.

Graphical Abstract

[1]
Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin., 2018, 68(6), 394-424.
[http://dx.doi.org/10.3322/caac.21492] [PMID: 30207593]
[2]
Brisson, M.; Kim, J.J.; Canfell, K.; Drolet, M.; Gingras, G.; Burger, E.A.; Martin, D.; Simms, K.T.; Bénard, É.; Boily, M.C.; Sy, S.; Regan, C.; Keane, A.; Caruana, M.; Nguyen, D.T.N.; Smith, M.A.; Laprise, J.F.; Jit, M.; Alary, M.; Bray, F.; Fidarova, E.; Elsheikh, F.; Bloem, P.J.N.; Broutet, N.; Hutubessy, R. Impact of HPV vaccination and cervical screening on cervical cancer elimination: A comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet, 2020, 395(10224), 575-590.
[http://dx.doi.org/10.1016/S0140-6736(20)30068-4] [PMID: 32007141]
[3]
Arbyn, M.; Weiderpass, E.; Bruni, L.; de Sanjosé, S.; Saraiya, M.; Ferlay, J.; Bray, F. Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. Lancet Glob. Health, 2020, 8(2), e191-e203.
[http://dx.doi.org/10.1016/S2214-109X(19)30482-6] [PMID: 31812369]
[4]
Nayar, R.; Wilbur, D.C. The Bethesda system for reporting cervical cytology: A historical perspective. Acta Cytol., 2017, 61(4-5), 359-372.
[http://dx.doi.org/10.1159/000477556] [PMID: 28693017]
[5]
Iavazzo, C.; Boutas, I.; Grigoriadis, C.; Vrachnis, N.; Salakos, N. Management of ASCUS findings in Papanicolaou smears. A retrospective study. Eur. J. Gynaecol. Oncol., 2012, 33(6), 605-609.
[PMID: 23327054]
[6]
Kececioglu, M.; Seckin, B.; Baser, E.; Togrul, C.; Kececioglu, T.S.; Cicek, M.N.; Gungor, T. Cost and effectiveness comparison of immediate colposcopy versus human papillomavirus DNA testing in management of atypical squamous cells of undetermined significance in Turkish women. Asian Pac. J. Cancer Prev., 2013, 14(1), 511-514.
[http://dx.doi.org/10.7314/APJCP.2013.14.1.511] [PMID: 23534785]
[7]
Cheung, L.C.; Egemen, D.; Chen, X.; Katki, H.A.; Demarco, M.; Wiser, A.L.; Perkins, R.B.; Guido, R.S.; Wentzensen, N.; Schiffman, M. 2019 ASCCP risk-based management consensus guidelines: Methods for risk estimation, recommended management, and validation. J. Low. Genit. Tract Dis., 2020, 24(2), 90-101.
[http://dx.doi.org/10.1097/LGT.0000000000000528] [PMID: 32243306]
[8]
Massad, L.S.; Einstein, M.H.; Huh, W.K.; Katki, H.A.; Kinney, W.K.; Schiffman, M.; Solomon, D.; Wentzensen, N.; Lawson, H.W. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J. Low. Genit. Tract Dis., 2013, 17(5)(Suppl. 1), S1-S27.
[http://dx.doi.org/10.1097/LGT.0b013e318287d329] [PMID: 23519301]
[9]
Stacey, D; Légaré, F; Lewis, K; Barry, MJ; Bennett, CL; Eden, KB Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst. Rev., 2017, 4(4), CD001431.
[http://dx.doi.org/10.1002/14651858.CD001431.pub5]
[10]
Coulter, A.; Ellins, J. Effectiveness of strategies for informing, educating, and involving patients. BMJ, 2007, 335(7609), 24-27.
[http://dx.doi.org/10.1136/bmj.39246.581169.80] [PMID: 17615222]
[11]
Elwyn, G.; Laitner, S.; Coulter, A.; Walker, E.; Watson, P.; Thomson, R. Implementing shared decision making in the NHS. BMJ, 2010, 341(oct14 2), c5146.
[http://dx.doi.org/10.1136/bmj.c5146] [PMID: 20947577]
[12]
Shay, L.A.; Lafata, J.E. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med. Decis. Making, 2015, 35(1), 114-131.
[http://dx.doi.org/10.1177/0272989X14551638] [PMID: 25351843]
[13]
Broström, A.; Pakpour, A.H.; Nilsen, P.; Hedberg, B.; Ulander, M. Validation of Collabo RATE and SURE – two short questionnaires to measure shared decision making during CPAP initiation. J. Sleep Res., 2019, 28(5), e12808.
[http://dx.doi.org/10.1111/jsr.12808] [PMID: 30549161]
[14]
Mehrabi, E.; Malekzadeh, E.; Nourizadeh, R.; Farshbaf-Khalili, A.; Hakimi, S. The effect of decision-aid-based counseling on cervical cancer screening behavior among women: An interventional study. J. Educ. Health Promot., 2022, 11(1), 205.
[http://dx.doi.org/10.4103/jehp.jehp_714_21] [PMID: 36003249]
[15]
Gokce, M.I.; Wang, X.; Frost, J.; Roberson, P.; Volk, R.J.; Brooks, D. Informed decision making prior to PSA screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men. Cancer, 2017, 123(4), 583.
[http://dx.doi.org/10.1002/cncr.30367] [PMID: 27727462]
[16]
Ruparel, M.; Quaife, S.L.; Ghimire, B.; Dickson, J.L.; Bhowmik, A.; Navani, N.; Baldwin, D.R.; Duffy, S.; Waller, J.; Janes, S.M. Impact of a lung cancer screening information film on informed decision-making: A randomized trial. Ann. Am. Thorac. Soc., 2019, 16(6), 744-751.
[http://dx.doi.org/10.1513/AnnalsATS.201811-841OC] [PMID: 31082267]
[17]
Manners, D.; Pettigrew, S.; Lake, F.R.; Piccolo, F.; McWilliams, A.M.; Brims, F.J.H. Development and evaluation of a consumer information resource, including Patient Decision Aid, for lung cancer screening: A quasi-experimental study. Transl. Behav. Med., 2020, 10(2), 404-412.
[http://dx.doi.org/10.1093/tbm/ibz029] [PMID: 30855087]
[18]
Lipschitz, J.M.; Paiva, A.L.; Redding, C.A.; Levesque, D.; Rossi, J.S.; Weisberg, R.B.; Prochaska, J.O. Development and preliminary psychometric evaluation of decisional balance and self-efficacy measures for managing anxiety in a national sample of clinically anxious adults. Am. J. Health Promot., 2018, 32(1), 215-223.
[http://dx.doi.org/10.1177/0890117116669493] [PMID: 27670270]
[19]
Jones, R.A.; Hollen, P.J.; Wenzel, J.; Weiss, G.; Song, D.; Sims, T.; Petroni, G. Understanding advanced prostate cancer decision-making utilizing an interactive decision aid. Cancer Nurs., 2018, 41(1), 2-10.
[http://dx.doi.org/10.1097/NCC.0000000000000442] [PMID: 27811543]
[20]
Shahveisi, M.; Nourizadeh, R.; Mehrabi, E. The effect of shared decision-making in choosing the method of labor analgesia on childbirth experience among primiparous women. PLoS One, 2023, 18(2), e0274559.
[http://dx.doi.org/10.1371/journal.pone.0274559] [PMID: 36791114]
[21]
Mousavizadeh, S.N.; Ilkhani, M. Patient decision aids and outcomes of its performance into routine clinical settings: A review article. Advances in Nursing & Midwifery., 2016, 25(89), 11-20.
[22]
Akbari, Z.; Mehrabi, E.; Mirghafourvand, M.; Nourizadeh, R. The effect of decision aid on breast cancer screening behaviors based on theory of stage of change: an interventional study. Crescent J. Med. Biol. Sci., 2020, 7(3), 404-408.
[23]
Alizadeh-Sabeg, P.; Mehrabi, E.; Nourizadeh, R.; Hakimi, S.; Mousavi, S. The effect of motivational interviewing on the change of breast cancer screening behaviors among rural Iranian women. Patient Educ. Couns., 2021, 104(2), 369-374.
[http://dx.doi.org/10.1016/j.pec.2020.08.011] [PMID: 32847705]
[24]
Pourebrahim-Alamdari, P.; Mehrabi, E.; Nikkhesal, N.; Nourizadeh, R.; Esmaeilpour, K.; Mousavi, S. Effectiveness of motivationally tailored interventions on cervical cancer screening: a systematic review and meta-analysis. Int. J. Women’s Health Reprod. Sci., 2020, 9(2), 086-090.
[http://dx.doi.org/10.15296/ijwhr.2021.16]
[25]
Alizadeh Sabeg, P.; Mehrabi, E.; Nourizadeh, R.; Poursharifi, H.; Mousavi, S. The effect of counseling on breast cancer awareness in rural Iranian women: A randomized controlled clinical trial. J. Cancer Educ., 2019, 34(6), 1083-1091.
[http://dx.doi.org/10.1007/s13187-018-1411-z] [PMID: 30088226]
[26]
Causarano, N.; Platt, J.; Baxter, N.N.; Bagher, S.; Jones, J.M.; Metcalfe, K.A.; Hofer, S.O.P.; O’Neill, A.C.; Cheng, T.; Starenkyj, E.; Zhong, T. Pre-consultation educational group intervention to improve shared decision-making for postmastectomy breast reconstruction: A pilot randomized controlled trial. Support. Care Cancer, 2015, 23(5), 1365-1375.
[http://dx.doi.org/10.1007/s00520-014-2479-6] [PMID: 25351455]
[27]
O’connor, A. User manual-decision self-efficacy scale; Ottawa Hospital Research Institute: Ottawa, 1995, p. 4.
[28]
O’Connor, A. User Manual–Decisional Conflict Scale (16 item statement format); Ottawa Hospital Research Institute: Ottawa, 1993.
[29]
O’Connor, A.M. Validation of a decisional conflict scale. Med. Decis. Making, 1995, 15(1), 25-30.
[http://dx.doi.org/10.1177/0272989X9501500105] [PMID: 7898294]
[30]
Brehaut, J.C.; O’Connor, A.M.; Wood, T.J.; Hack, T.F.; Siminoff, L.; Gordon, E.; Feldman-Stewart, D. Validation of a decision regret scale. Med. Decis. Making, 2003, 23(4), 281-292.
[http://dx.doi.org/10.1177/0272989X03256005] [PMID: 12926578]
[31]
McCaffery, K.J.; Irwig, L.; Chan, S.F.; Macaskill, P.; Barratt, A.; Lewicka, M.; Clarke, J.; Weisberg, E. HPV testing versus repeat Pap testing for the management of a minor abnormal Pap smear: Evaluation of a decision aid to support informed choice. Patient Educ. Couns., 2008, 73(3), 473-481. 481
[http://dx.doi.org/10.1016/j.pec.2008.07.021] [PMID: 18757164]
[32]
Elwyn, G.; Tsulukidze, M.; Edwards, A.; Légaré, F.; Newcombe, R. Using a ‘talk’ model of shared decision making to propose an observation-based measure: Observer OPTION5 Item. Patient Educ. Couns., 2013, 93(2), 265-271.
[http://dx.doi.org/10.1016/j.pec.2013.08.005] [PMID: 24029581]
[33]
Sheehan, J.; Sherman, K.A. Computerised decision aids: A systematic review of their effectiveness in facilitating high-quality decision-making in various health-related contexts. Patient Educ. Couns., 2012, 88(1), 69-86.
[http://dx.doi.org/10.1016/j.pec.2011.11.006] [PMID: 22185961]
[34]
Schonberg, M.A.; Hamel, M.B.; Davis, R.B.; Griggs, M.C.; Wee, C.C.; Fagerlin, A.; Marcantonio, E.R. Development and evaluation of a decision aid on mammography screening for women 75 years and older. JAMA Intern. Med., 2014, 174(3), 417-424.
[http://dx.doi.org/10.1001/jamainternmed.2013.13639] [PMID: 24378846]
[35]
Martínez-Alonso, M.; Carles-Lavila, M.; Pérez-Lacasta, M.J.; Pons-Rodríguez, A.; Garcia, M.; Rué, M. Assessment of the effects of decision aids about breast cancer screening: A systematic review and meta-analysis. BMJ Open, 2017, 7(10), e016894.
[http://dx.doi.org/10.1136/bmjopen-2017-016894] [PMID: 28988175]
[36]
Wang, T.J.; Chiu, P.P.; Chen, K.K.; Hung, L.P. Efficacy of a decision support intervention for reducing decisional conflict in patients with elevated serum prostate-specific antigen: A randomized controlled trial. Eur. J. Oncol. Nurs., 2021, 50, 101865.
[http://dx.doi.org/10.1016/j.ejon.2020.101865] [PMID: 33212360]
[37]
Politi, M.C.; Kuzemchak, M.D.; Kaphingst, K.A.; Perkins, H.; Liu, J.; Byrne, M.M. Decision aids can support cancer clinical trials decisions: Results of a randomized trial. Oncologist, 2016, 21(12), 1461-1470.
[http://dx.doi.org/10.1634/theoncologist.2016-0068] [PMID: 27511904]
[38]
Bailey, R.A.; Pfeifer, M.; Shillington, A.C.; Harshaw, Q.; Funnell, M.M.; VanWingen, J.; Col, N. Effect of a patient decision aid (PDA) for type 2 diabetes on knowledge, decisional self-efficacy, and decisional conflict. BMC Health Serv. Res., 2015, 16(1), 10.
[http://dx.doi.org/10.1186/s12913-016-1262-4] [PMID: 26762150]
[39]
Ghiyasvandian, S.; Dehghan Nayeri, N.; Haghani, H. The effect of decision Aid’s Pakage in selected treatment by patients with early stage breast Cancer and decision making outcomes. J. Adv. Biomed. Sci., 2013, 3(3), 271-279.
[40]
Nicolai, J.; Buchholz, A.; Seefried, N.; Reuter, K.; Härter, M.; Eich, W.; Bieber, C. When do cancer patients regret their treatment decision? A path analysis of the influence of clinicians’ communication styles and the match of decision-making styles on decision regret. Patient Educ. Couns., 2016, 99(5), 739-746.
[http://dx.doi.org/10.1016/j.pec.2015.11.019] [PMID: 26658703]
[41]
Peate, M.; Meiser, B.; Cheah, B.C.; Saunders, C.; Butow, P.; Thewes, B.; Hart, R.; Phillips, K-A.; Hickey, M.; Friedlander, M. Making hard choices easier: A prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. Br. J. Cancer, 2012, 106(6), 1053-1061.
[http://dx.doi.org/10.1038/bjc.2012.61] [PMID: 22415294]
[42]
Wang, Y.; Anazodo, A.; Logan, S. Systematic review of fertility preservation patient decision aids for cancer patients. Psychooncology, 2019, 28(3), 459-467.
[http://dx.doi.org/10.1002/pon.4961] [PMID: 30523651]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy