Julia K Shinnick, Araba A Jackson, Russel Stanley, Tasha Serna-Gallegos, Brittni Boyd, Ivrose Joseph, Deepanjana Das, Anna Pancheshnikov, Matthew M Scarpaci, Vivian W Sung
{"title":"新患者就诊后与脱垂治疗相关的决策冲突。","authors":"Julia K Shinnick, Araba A Jackson, Russel Stanley, Tasha Serna-Gallegos, Brittni Boyd, Ivrose Joseph, Deepanjana Das, Anna Pancheshnikov, Matthew M Scarpaci, Vivian W Sung","doi":"10.1097/SPV.0000000000001570","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Patients with pelvic organ prolapse are often tasked with deciding between treatments. Decisional conflict is a measure of factors that go into effective decision making.</p><p><strong>Objective: </strong>This study aimed to compare prolapse treatment-related decisional conflict reported by underrepresented patients (URPs) to non-URPs after new patient visits.</p><p><strong>Study design: </strong>A multicenter cohort study of new patients counseled regarding management of prolapse from July 2021 to December 2022 was performed. Participants completed the Decisional Conflict Scale (DCS), a validated measure of modifiable factors in decision making. Higher scores indicate feeling less comfortable with decisions. Race and ethnicity were viewed as social constructs. A URP was defined as self-identification with a non-White race or Hispanic ethnicity. Alpha was set at 0.05, power 80%, to detect an effect size of 0.4 between mean DCS scores.</p><p><strong>Results: </strong>A total of 207 participants (103 URPs, 49.8%), with a mean age of 63.4 ± 11.9 years and mean body mass index of 29.7 ± 6.9 (calculated as weight in kilograms divided by height in meters squared), completed the study. Much of the URP group self-identified as Hispanic (50/103, 48.5%) and/or Black (39/103, 37.9%), and 30 of 103 (29.1%) had an interpreter at their visit. A greater proportion of non-URPs had a prior hysterectomy (16.1% difference; P = 0.017) and prolapse surgery (18/204, 10.5% difference; P = 0.020). A greater proportion of URPs had hypertension (23.6% difference; P = <0.001). There were no differences in the other pelvic floor disorders, prolapse stage, or treatments selected (all P > 0.05). The mean DCS scores were not different between groups (URP, 12.9 ± 12.3 vs non-URP, 11.6 ± 14.9; P = 0.31). Household income, education, and insurance were not associated with DCS scores (all P > 0.05).</p><p><strong>Conclusions: </strong>Decisional Conflict Scale scores were not significantly different between groups. Possible differences between subgroups warrant further investigation.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prolapse Treatment-Related Decisional Conflict After New Patient Visits.\",\"authors\":\"Julia K Shinnick, Araba A Jackson, Russel Stanley, Tasha Serna-Gallegos, Brittni Boyd, Ivrose Joseph, Deepanjana Das, Anna Pancheshnikov, Matthew M Scarpaci, Vivian W Sung\",\"doi\":\"10.1097/SPV.0000000000001570\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Patients with pelvic organ prolapse are often tasked with deciding between treatments. Decisional conflict is a measure of factors that go into effective decision making.</p><p><strong>Objective: </strong>This study aimed to compare prolapse treatment-related decisional conflict reported by underrepresented patients (URPs) to non-URPs after new patient visits.</p><p><strong>Study design: </strong>A multicenter cohort study of new patients counseled regarding management of prolapse from July 2021 to December 2022 was performed. Participants completed the Decisional Conflict Scale (DCS), a validated measure of modifiable factors in decision making. Higher scores indicate feeling less comfortable with decisions. Race and ethnicity were viewed as social constructs. A URP was defined as self-identification with a non-White race or Hispanic ethnicity. Alpha was set at 0.05, power 80%, to detect an effect size of 0.4 between mean DCS scores.</p><p><strong>Results: </strong>A total of 207 participants (103 URPs, 49.8%), with a mean age of 63.4 ± 11.9 years and mean body mass index of 29.7 ± 6.9 (calculated as weight in kilograms divided by height in meters squared), completed the study. Much of the URP group self-identified as Hispanic (50/103, 48.5%) and/or Black (39/103, 37.9%), and 30 of 103 (29.1%) had an interpreter at their visit. A greater proportion of non-URPs had a prior hysterectomy (16.1% difference; P = 0.017) and prolapse surgery (18/204, 10.5% difference; P = 0.020). A greater proportion of URPs had hypertension (23.6% difference; P = <0.001). There were no differences in the other pelvic floor disorders, prolapse stage, or treatments selected (all P > 0.05). The mean DCS scores were not different between groups (URP, 12.9 ± 12.3 vs non-URP, 11.6 ± 14.9; P = 0.31). Household income, education, and insurance were not associated with DCS scores (all P > 0.05).</p><p><strong>Conclusions: </strong>Decisional Conflict Scale scores were not significantly different between groups. Possible differences between subgroups warrant further investigation.</p>\",\"PeriodicalId\":75288,\"journal\":{\"name\":\"Urogynecology (Hagerstown, Md.)\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urogynecology (Hagerstown, Md.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/SPV.0000000000001570\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urogynecology (Hagerstown, Md.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/SPV.0000000000001570","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/27 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Prolapse Treatment-Related Decisional Conflict After New Patient Visits.
Importance: Patients with pelvic organ prolapse are often tasked with deciding between treatments. Decisional conflict is a measure of factors that go into effective decision making.
Objective: This study aimed to compare prolapse treatment-related decisional conflict reported by underrepresented patients (URPs) to non-URPs after new patient visits.
Study design: A multicenter cohort study of new patients counseled regarding management of prolapse from July 2021 to December 2022 was performed. Participants completed the Decisional Conflict Scale (DCS), a validated measure of modifiable factors in decision making. Higher scores indicate feeling less comfortable with decisions. Race and ethnicity were viewed as social constructs. A URP was defined as self-identification with a non-White race or Hispanic ethnicity. Alpha was set at 0.05, power 80%, to detect an effect size of 0.4 between mean DCS scores.
Results: A total of 207 participants (103 URPs, 49.8%), with a mean age of 63.4 ± 11.9 years and mean body mass index of 29.7 ± 6.9 (calculated as weight in kilograms divided by height in meters squared), completed the study. Much of the URP group self-identified as Hispanic (50/103, 48.5%) and/or Black (39/103, 37.9%), and 30 of 103 (29.1%) had an interpreter at their visit. A greater proportion of non-URPs had a prior hysterectomy (16.1% difference; P = 0.017) and prolapse surgery (18/204, 10.5% difference; P = 0.020). A greater proportion of URPs had hypertension (23.6% difference; P = <0.001). There were no differences in the other pelvic floor disorders, prolapse stage, or treatments selected (all P > 0.05). The mean DCS scores were not different between groups (URP, 12.9 ± 12.3 vs non-URP, 11.6 ± 14.9; P = 0.31). Household income, education, and insurance were not associated with DCS scores (all P > 0.05).
Conclusions: Decisional Conflict Scale scores were not significantly different between groups. Possible differences between subgroups warrant further investigation.
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