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Yu L, Gong J, Sun X, Zang M, Liu L, Yu S. Assessing the Content and Effect of Web-Based Decision Aids for Postmastectomy Breast Reconstruction: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Med Internet Res 2024; 26:e53872. [PMID: 38801766 PMCID: PMC11165285 DOI: 10.2196/53872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Web-based decision aids have been shown to have a positive effect when used to improve the quality of decision-making for women facing postmastectomy breast reconstruction (PMBR). However, the existing findings regarding these interventions are still incongruent, and the overall effect is unclear. OBJECTIVE We aimed to assess the content of web-based decision aids and its impact on decision-related outcomes (ie, decision conflict, decision regret, informed choice, and knowledge), psychological-related outcomes (ie, satisfaction and anxiety), and surgical decision-making in women facing PMBR. METHODS This systematic review and meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 6 databases, PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science Core Collection, were searched starting at the time of establishment of the databases to May 2023, and an updated search was conducted on April 1, 2024. MeSH (Medical Subject Headings) terms and text words were used. The Cochrane Risk of Bias Tool for randomized controlled trials was used to assess the risk of bias. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS In total, 7 studies included 579 women and were published between 2008 and 2023, and the sample size in each study ranged from 26 to 222. The results showed that web-based decision aids used audio and video to present the pros and cons of PMBR versus no PMBR, implants versus flaps, and immediate versus delayed PMBR and the appearance and feel of the PMBR results and the expected recovery time with photographs of actual patients. Web-based decision aids help improve PMBR knowledge, decisional conflict (mean difference [MD]=-5.43, 95% CI -8.87 to -1.99; P=.002), and satisfaction (standardized MD=0.48, 95% CI 0.00 to 0.95; P=.05) but have no effect on informed choice (MD=-2.80, 95% CI -8.54 to 2.94; P=.34), decision regret (MD=-1.55, 95% CI -6.00 to 2.90 P=.49), or anxiety (standardized MD=0.04, 95% CI -0.50 to 0.58; P=.88). The overall Grading of Recommendations, Assessment, Development, and Evaluation quality of the evidence was low. CONCLUSIONS The findings suggest that the web-based decision aids provide a modern, low-cost, and high dissemination rate effective method to promote the improved quality of decision-making in women undergoing PMBR. TRIAL REGISTRATION PROSPERO CRD42023450496; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450496.
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Affiliation(s)
- Lin Yu
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Jianmei Gong
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Xiaoting Sun
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Min Zang
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Lei Liu
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Shengmiao Yu
- Outpatient Department, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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Al-Aroomi MA, Al-Worafi NA, Ma Y, Alkebsi K, Mohamed AAS, Jiang C. Patient-reported outcomes after oral cancer reconstructions with radial and ulnar forearm-free flaps. Oral Dis 2024. [PMID: 38696366 DOI: 10.1111/odi.14968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES This study aimed to evaluate patient-reported quality of life and incidence of decision regret in patients undergoing radial (RFFF) and ulnar forearm-free flaps (UFFF) reconstruction. MATERIALS AND METHODS Patients undergoing either RFFF or UFFF were assessed with the University of Washington Quality of Life (UW-QOL) and Oral Health Impact Profile (OHIP-14) questionnaires, and the Decision Regret Scale (DRS), both before and at least 12 months post-reconstruction. RESULTS In total, 40 RFFF and 40 UFFF were included. Harvesting time was longer in RFFF (p = 0.043), and the donor-site defect was significantly larger in RFFF than in UFFF (p = 0.044). Patients with UFFF scored better UW-QOL in the appearance, pain, activity, mood, and social functioning domains (p < 0.05). However, the RFFF group excelled in swallowing and chewing domains. The DRS score revealed a significant difference between RFFF and UFFF, with scores of 36.26 versus 27.36, respectively. Moreover, the mean DRS score reduced at 12 months compared with 6 months, significantly superior for UFFF. CONCLUSION Oral cancer patients reconstructed with UFFF exhibited a better appearance, social domain, and mild decision regret compared with RFFF, indicating that the UFFF may contribute to improving postoperative quality of life in oral cancer patients.
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Affiliation(s)
- Maged Ali Al-Aroomi
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
- Faculty of Dentistry, Ibb University, Ibb, Yemen
| | | | - Yujie Ma
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | | | | | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
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Wen FH, Hsieh CH, Su PJ, Shen WC, Hou MM, Chou WC, Chen JS, Chang WC, Tang ST. Factors Associated With Family Surrogate Decisional-Regret Trajectories. J Pain Symptom Manage 2024; 67:223-232.e2. [PMID: 38036113 DOI: 10.1016/j.jpainsymman.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023]
Abstract
CONTEXT/OBJECTIVES The scarce research on factors associated with surrogate decisional regret overlooks longitudinal, heterogenous decisional-regret experiences and fractionally examines factors from the three decision-process framework stages: decision antecedents, decision-making process, and decision outcomes. This study aimed to fill these knowledge gaps by focusing on factors modifiable by high-quality end-of-life (EOL) care. METHODS This observational study used a prior cohort of 377 family surrogates of terminal-cancer patients to examine factors associated with their membership in the four preidentified distinct decisional-regret trajectories: resilient, delayed-recovery, late-emerging, and increasing-prolonged trajectories from EOL-care decision making through the first two bereavement years by multinomial logistic regression modeling using the resilient trajectory as reference. RESULTS Decision antecedent factors: Financial sufficiency and heavier caregiving burden increased odds for the delayed-recovery trajectory. Spousal loss, higher perceived social support during an EOL-care decision, and more postloss depressive symptoms increased odds for the late-emerging trajectory. More pre- and postloss depressive symptoms increased odds for the increasing-prolonged trajectory. Decision-making process factors: Making an anticancer treatment decision and higher decision conflict increased odds for the delayed-recovery and increasing-prolonged trajectories. Making a life-sustaining-treatment decision increased membership in the three more profound trajectories. Decision outcome factors: Greater surrogate appraisal of quality of dying and death lowered odds for the three more profound trajectories. Patient receipt of anticancer or life-sustaining treatments increased odds for the late-emerging trajectory. CONCLUSION Surrogate membership in decisional-regret trajectories was associated with decision antecedent, decision-making process, and decision outcome factors. Effective interventions should target identified modifiable factors to address surrogate decisional regret.
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Affiliation(s)
- Fur-Hsing Wen
- Department of International Business (F.H.W.), Soochow University, Taipei, Taiwan
| | - Chia-Hsun Hsieh
- College of Medicine (C.H.H., W.C.C., J.S.C., W.C.C.), Chang Gung University, Tao-Yuan, Taiwan; Division of Hematology-Oncology (C.H.H.), Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| | - Po-Jung Su
- Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Wen-Chi Shen
- Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Ming-Mo Hou
- Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Wen-Chi Chou
- College of Medicine (C.H.H., W.C.C., J.S.C., W.C.C.), Chang Gung University, Tao-Yuan, Taiwan; Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Jen-Shi Chen
- College of Medicine (C.H.H., W.C.C., J.S.C., W.C.C.), Chang Gung University, Tao-Yuan, Taiwan; Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Wen-Cheng Chang
- College of Medicine (C.H.H., W.C.C., J.S.C., W.C.C.), Chang Gung University, Tao-Yuan, Taiwan; Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Siew Tzuh Tang
- Division of Hematology-Oncology (P.J.S., W.C.S., M.M.H., W.C.C., J.S.C., W.C.C., S.T.T.), Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; School of Nursing, Medical College (S.T.T.), Chang Gung University, Tao-Yuan, Taiwan; Department of Nursing (S.T.T.), Chang Gung Memorial Hospital at Kaohsiung, Taiwan; Department of Nursing (S.T.T.), Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.
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Kuo HC, Lee WY, Hsu HC, Creedy DK, Tsao Y. Effectiveness of a Digital Decision Aid for Nutrition Support in Women with Gynaecological Cancer: A Comparative Study. Nutr Cancer 2024; 76:325-334. [PMID: 38327136 DOI: 10.1080/01635581.2024.2307649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024]
Abstract
This study aimed to examine the effects of an animated Patient Decision Aid (PtDA) about dietary choices on decisional conflict and decision regret. A prospective, observational, two-group comparative effectiveness study was conducted with patients (n = 90) from a southern Taiwan oncology inpatient unit. Data included the Malnutrition Universal Screening Tool (MUST), laboratory results, 16-item Decisional Conflict Scale (sf-DCS), and 5-item Decision Regret Scale (DRSc). Data were collected at admission (T0), after the first-cycle of chemotherapy but before discharge (T1), and after the six-cycle chemotherapy protocol (T2) (around 3 months). Group A received standardized nutrition education and a printed brochure, while Group B watched a 10-minute information video during a one-on-one inpatient consultation and engaged in a values clarification exercise between T0 and T1. The percentage of women with a MUST score ≧1 in Group A sharply increased over time, but not in Group B. Decision aid usage significantly increased patients' hemoglobin and lymphocyte values over time (p < 0.05). The digital PtDA contributed to less decisional conflict and decision regret in at-risk patients and improved their nutritional well-being. Decision-aids help patients make healthcare decisions in line with their values, and are sustainable for use by busy clinicians.
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Affiliation(s)
- Hoi-Chen Kuo
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen-Ying Lee
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hui-Chun Hsu
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Debra K Creedy
- School of Nursing & Midwifery, Griffith University, Nathan, Australia
| | - Ying Tsao
- Department of Nursing, Tzu-Chi University, Hualien, Taiwan
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Li J, Luo Z, Chen Y, Zhao Q, Zhang S, Zhou W, Peng Y, Chen L, Song Y, Yang X, Li J, Tang J. Measuring care-related regret intensity: Reliability and validation of a 10-item scale among Chinese nursing interns. Nurse Educ Pract 2024; 74:103845. [PMID: 38007846 DOI: 10.1016/j.nepr.2023.103845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Abstract
AIM The 10-item care-related regret intensity scale (RIS-10) assesses the experience and intensity of care-related regrets. The aim of this study was to validate a Chinese version of the RIS and examine its reliability and validity when applied to Chinese nursing interns. BACKGROUND Nursing students, the future healthcare workforce, often face clinical errors and adverse events due to limited knowledge and experience. Assessing care-related regret during their internships is crucial for their development. METHODS Through a process involving translation, back-translation and cross-cultural adaptation, a Chinese version of the RIS-10 was developed. A convenience sampling method was employed to survey 529 nursing interns to validate the reliability and validity of the scale. RESULTS The Chinese version of the scale, consisting of 10 items, demonstrated a single dimension, explaining 66.77% of the total variance according to exploratory factor analysis. Content validity for the 10 items ranged from 0.800 to 1.000, with a scale-level content validity of 0.980. Confirmatory factor analysis indicated a well-fitting model (CFI = 0.968, GFI = 0.921, NFI = 0.952, IFI = 0.969, TLI = 0.957, RMSEA = 0.088). Convergent validity was supported by an Average Variance Extracted of 0.636 and a Composite Reliability of 0.946. The scale also exhibited strong reliability with a Cronbach's α coefficient of 0.945, a split-half reliability coefficient of 0.903 and a test-retest reliability of 0.901. CONCLUSIONS This comprehensive translation and validation process confirms the suitability of the Chinese version of the RIS-10 for use among Chinese nursing interns.
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Affiliation(s)
- Jie Li
- West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhongchen Luo
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Yanhan Chen
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | | | - Wei Zhou
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Peng
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lijuan Chen
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqing Song
- School of nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Yang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Li
- Academic Affairs Office, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Jiao Tang
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Li Y, Yang T, Ju L, Feng Y, Chen Z, Xiang X, Zhu T, Pang H, Wang Z. Quality of life and decision regret in patients with late-hypothyroidism after radioiodine treatment for Graves' disease. Clin Endocrinol (Oxf) 2024; 100:87-95. [PMID: 37964632 DOI: 10.1111/cen.14986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE Patients with Graves' disease often engage in shared decision-making to select an individualised treatment regimen from multiple options. Radioactive iodine (RAI) is one of the treatment choices for their condition, aims to improve quality of life and well-being. Likewise, dissatisfaction with treatment outcomes can result in decision regret. We employed validated questionnaires to assess the prospective quality of life, decision regret and relative factors involved in decision-making of patients with late hypothyroidism after RAI therapy. METHODS A questionnaire survey was conducted among patients in hypothyroidism status for more than 1 year after RAI therapy. Disease-specific and generic QoL were assessed using the short form of thyroid-related patient-reported outcome (ThyPRO-39) questionnaire. Patient satisfaction regarding their decision to undergo RAI was assessed using the Decision Regret Scale (DRS) and patients were asked about the importance of relative factors in decision-making. RESULTS Of 254 patients who responded to the survey, the mean age of patients was 45.3 years (range: 18-78 years) and the median time from RAI therapy to survey was 4 years (range: 1-30 years). Patients' median and mean DRS score were 34.4 and 38.8 (range: 0-100), respectively. A total of 100 (39.4%) patients express absent-to-mild regret (score: 0-25), 154 (60.6%) patients express moderate-to-severe regret (score: >25). The mean score of the absent-to-mild regret group were significantly higher than those of the moderate-to-severe regret group on most ThyPRO-39 scales. A statistically significant positive correlation was observed between DRS score and most ThyPRO-39 scale score. There was a significant positive association between higher DRS score and longer time intervals after RAI treatment, a brief duration of hyperthyroidism, and the significance of long-time outpatient follow-up. More decision regret was negatively associated Iodine-free diet, ineffectiveness of ATD, fear of surgery. CONCLUSION Impairment of quality of life was positively correlated with decision regret in patients with late-hypothyroidism after radioiodine therapy. Patients with insufficient information support before decision-making are more likely to have higher decision regret after treatment. Our findings suggest that health providers should fully communicate with patients and provide information support in multiple dimensions during the shared-decision-making process.
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Affiliation(s)
- Yue Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tianyu Yang
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linjun Ju
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuyue Feng
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Chen
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xing Xiang
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tao Zhu
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Pang
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhengjie Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Xu RH, Wang LL, Zhou LM, Wong ELY, Wang D. Assessment of eHealth literacy to reduce financial toxicity and improve shared decision-making in cancer patients: A cross-sectional study. Digit Health 2023; 9:20552076231181475. [PMID: 37334320 PMCID: PMC10272650 DOI: 10.1177/20552076231181475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/25/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives This study aimed to investigate the associations between eHealth literacy, preferences for financial decision-making, and financial toxicity (FT) in a sample of Chinese cancer patients. Methods Eligible cancer patients were invited to participate in a cross-sectional survey from January to April 2021. Three measures (eHealth literacy scale, control preference scale, and COST) were used to analyze patients' eHealth literacy, decisional preferences, and FT, respectively. Wilcoxon signed-rank test and Kruskal-Wallis H test assessed the differences between population subgroups. Binary logistic and multivariate linear regression models were used to assess the relationships between eHealth literacy, decisional preferences, and FT. Results A total of 590 cancer patients completed the questionnaire. We found that high FT was associated with poor ECOG performance, severe cancer stage, and longer cancer duration. Patients who preferred to adopt collaborative attitude toward decision-making showed a significantly higher eHealth literacy. However, there was an inverse relationship between eHealth literacy and a patient-driven attitude toward decision-making in female cancer patients. Regression analysis indicated that patients who were highly educated and actively employed might report a higher eHealth literacy. A significant relationship was found between high eHealth literacy and low FT. However, this relationship became insignificant when the background characteristics of cancer patients were taken into account. Conclusions A relationship between enhanced eHealth literacy, preference for collaborative decision-making, and low risk of FT is identified. Practical implication Interventions to improve patients' ability to use quality and reliable web-based information on cancer care should be encouraged.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ling-ling Wang
- Department of Blood Transfusion Medicine, School of Medicine, Nanjing University, Nanjing, China
| | - Ling-ming Zhou
- Department of Human Resource, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Eliza Lai-yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
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Diotaiuti P, Valente G, Mancone S, Grambone A, Chirico A, Lucidi F. The use of the Decision Regret Scale in non-clinical contexts. Front Psychol 2022; 13:945669. [PMID: 36186382 PMCID: PMC9520623 DOI: 10.3389/fpsyg.2022.945669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/25/2022] [Indexed: 11/18/2022] Open
Abstract
The Decision Regret Scale (DRS) was assessed for its psychometric qualities in measuring decision regret in ordinary life scenarios. Although the scale has typically been used with patients and in the context of medical decision-making in earlier studies, this contribution shows that the instrument may have a variety of uses, retaining excellent metric properties even in non-medical contexts. The tool showed good fits with both the CFA and the gender Measurement Invariance. A non-probabilistic selection of 2,534 Italian university students was conducted. The internal consistency measures were found to be completely appropriate. Correlations with the General Decision-Making Style (GDMS) and Scale of Regulatory Modes were used to check for convergent validity (SRM). Convergence analysis showed that participants with higher regret scores were those who favored a rational decision-making style, while lower regret scores correlated with avoidant and spontaneous styles. With regard to the regulatory modes, the relationship between regret and locomotion was positive. Overall, the directions of association point to an interesting predictive measure of a person's decision-making and self-regulatory orientation through the evaluation of regret using the DRS. The excellent psychometric properties found foreshadow a reliable use in various contexts where knowledge of post-decisional attitude becomes important: school, university, professional orientation, marketing studies, relationship choices, as well as for use in research.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Italy
| | - Giuseppe Valente
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Italy
| | - Angela Grambone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Fabio Lucidi
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
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Xu RH, Keetharuth AD, Wang LL, Cheung AWL, Wong ELY. Measuring health-related quality of life and well-being: a head-to-head psychometric comparison of the EQ-5D-5L, ReQoL-UI and ICECAP-A. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:165-176. [PMID: 34338898 PMCID: PMC8327050 DOI: 10.1007/s10198-021-01359-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/20/2021] [Indexed: 05/16/2023]
Abstract
OBJECTIVE This study aimed to assess the psychometric properties of three generic preference-based measures and compare their performance in a sample of Hong Kong general population. METHODS Data used for this analysis were obtained from a cross-sectional telephone-based survey in July 2020. Participants were asked to complete several measures, including The EuroQol five-dimensional five levels (EQ-5D-5L), Recovering Quality of Life-Utility Index (ReQoL-UI) and ICEpop CAPability measure for adults (ICECAP-A). Acceptability, reliability, convergent and discriminant validity of three measures were assessed as well as the agreement between these instruments. RESULTS Based on data from 500 participants to the survey, a lower mean score of the ICECAP-A (mean = 0.85) was observed compared to the other two measures (meanReQoL-UI = 0.92; meanEQ-5D-5L = 0.92). All three measures showed an acceptable internal consistency reliability (Cronbach's alpha = 0.74, 0.82 and 0.77, respectively) as well as good test-retest reliability (intra-class correlation coefficient = 0.74, 0.82 and 0.77, respectively). Correlation analyses confirmed satisfactory convergent validity and the ability of the measures to differentiate between participants with different health or from socioeconomic status groups. The Bland-Altman plot revealed poor agreement between the three measures. CONCLUSIONS This study confirmed that EQ-5D-5L, ReQoL-UI and ICECAP-A were psychometrically robust to measure HRQoL in the general HK population. The EQ-5D-5L was more suitable for assessing physical HRQoL, whereas the ICECAP-A and ReQoL-UI were more appropriate for measuring interventions aimed at improving people's well-being and mental health.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | - Ling-Ling Wang
- Department of Blood Transfusion, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Xu RH, Zhou LM, Wong ELY, Chang J, Wang D. Satisfaction With Patient Engagement and Self-Reported Depression Among Hospitalized Patients: A Propensity-Score Matching Analysis. Front Psychiatry 2022; 13:751412. [PMID: 35356709 PMCID: PMC8959894 DOI: 10.3389/fpsyt.2022.751412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 02/09/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Depression is common among hospitalized patients and poses a significant threat to their quality of life. Patient engagement (PE) in healthcare has been shown to be associated with positive health outcomes. However, the relationship between PE and depression among hospitalized patients, with and without chronic conditions, has not yet been explored. This study aimed to investigate the association between patients' satisfaction with PE and self-reported depression in Chinese public hospitals. METHOD A multi-centered, cross-sectional survey was conducted in seven tertiary-level public hospitals in Guangdong province, China. Twelve items from a patient-centered care questionnaire and the Patient Health Questionnaire 2-item version were used were used to assess patients' satisfaction with PE and self-reported depression, respectively. Propensity score matching (PSM) approach was used to reduce selection bias and potential baseline differences between patients with and without chronic conditions. The relationship between satisfaction with PE and depression was assessed, using univariate and multivariate logistic regression analyses, respectively. RESULTS A total of 1,974 hospitalized patients participated in the survey. After the PSM procedure, 604 patients were assigned to the chronic condition group, and another 604 patients were successfully matched in the comparison group with no differences in sex, age, educational level, and PE-related characteristics. Univariate logistic regression analysis indicated that high satisfaction with PE-related approaches significantly decreased the probability of developing depressive status. Multivariate logistic regression analysis further indicated that, after adjusting all PE-related approaches, "patient education" and "involvement in discharge planning" could significantly decrease the probability of patients developing depression. CONCLUSIONS Our results indicate that encouraging PE and improving patients' satisfaction with PE interventions in clinical practice led to improved mental health outcomes among hospitalized patients in China.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ling-Ming Zhou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
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Xu RH, Zhou LM, Wang D. The Relationship Between Decisional Regret and Well-Being in Patients With and Without Depressive Disorders: Mediating Role of Shared Decision-Making. Front Psychiatry 2021; 12:657224. [PMID: 34220572 PMCID: PMC8242166 DOI: 10.3389/fpsyt.2021.657224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background: The objectives of this study were two-fold: (1) to assess the relationship between patients' decisional regret and their well-being and (2) to examine the mediated effect of shared decision-making (SDM) on this relationship. Methods: A cross-sectional survey was conducted in five cities in Southern China. Patients were asked to fill out questionnaires assessing their decisional regret, SDM, subjective well-being, and depressive status. Mediation analysis was used to investigate the effect of SDM on the relationship between patients' decisional regret and their subjective well-being. Results: The findings showed significant direct negative effects of decisional regret on subjective well-being and SDM. For non-depressive patients, SDM exerted a significant and indirect effect on reducing the negative influence of decisional regret on subjective well-being. Conclusions: Findings suggest that implementation of SDM can decrease patients' decisional regret and improve their well-being; however, there is a need to examine their depressive status as part of routine healthcare.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Center for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ling-Ming Zhou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
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