Original Articles

Factors Influencing Pregnant Women’s Use of Patient Decision Aids and Decision Making on Prenatal Screening: A Qualitative Study

Abstract

Objective: We aimed to identify factors influencing pregnant women’s use of patient decision aids (PtDA) and decision making on prenatal screening.
Materials and methods: This qualitative study was conducted between July 2019 and June 2020 in Tehran, Iran. The sample included 26 pregnant women selected by purposive sampling. The participants used a prenatal screening PtDA, then interviewed about factors that would influence their decision making and use of decision aids. The data were analyzed by conventional content analysis.
Results: Three categories were identified for the process of and factors influencing decision making, including the current decision making process, expected decision making process, and factors influencing decision making. Also, five categories were identified as factors affecting the use of PtDAs, including the content of decision aids, the appearance of decision aids, the decision aid platform, the provision of decision aids, and the sub features of decision aids.
Conclusion: To design, develop, and implementation of PtDAs for pregnant women, one should identify the factors affecting pregnant women’s decision making and the use of decision aids. This study helped to the identification of these factors, which is the first step towards the use of PtDAs by pregnant women and their participation in decision making.

1. Sedaghati P, Ardjmand A, Sedaghati N. Does Regular Ergometeric Training Have Any Effect On the Pregnancy Outcome? Iran Jurnal of Pediatr 2006; 16: 325-31.
2. Memari A, Ramim T, Amini M, Mehran A, Ajorloo A, Shakibaei P. Investigation of effects of aerobic exercise on pregnancy and its circumstances. "HAYAT" Nursing & Midwifery, TehranUniversity of Medical Sciences 2006; 12: 35-41
3. Simelela N. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization, 2018.
4. Cunningham F, Leveno K, Bloom S. Williams Obstetrics. 23th ed. New York: McGraw-Hill Medical 2010: 287–311.
5. Zali M. New basic relationship between patient and physician. Tehran: Hoghoghi publication, 2009.
6. World Health Organization, UNICEF, United Nations Population Fund. Managing complications in pregnancy and childbirth: a guide for midwives and doctors – 2nd ed. Geneva: World Health Organization, 2017.
7. Coulter A, Collins A. Making shared decision making a reality. London: King's Fund, 2011.
8. Graham ID, Logan J, Bennett CL, Presseau J, O'Connor AM, Mitchell SL, et al. Physicians' intentions and use of three patient decision aids. BMC Med Inform Decis Mak 2007; 7: 20.
9. Knops AM, Legemate DA, Goossens A, Bossuyt PM, Ubbink DT, et al. Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis. Ann Surg 2013; 257: 860–6.
10. Dahl K, Hvidman L, Jørgensen FS, Henriques C,
Olesen F, Kjaergaard H, et al. First-trimester Down syndrome screening: pregnant women's knowledge. Ultrasound Obstet Gynecol 2011; 38: 145-51.
11. Godin G. [Les comportements dans le domaine de la santé: comprendre pourmieux intervenir.] Montreal: The University of Montreal Press; 2012.
12. Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2014; 1: CD001431.
13. Moca, D S. Should patient decision aids (PtDAs) be introduced in the health care system? Copenhagen: WHO Regional Office for Europe, 2005.
14. Alden DL, Friend J, Schapira M, Stiggelbout A. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups. Soc Sci Med 2014; 105: 1-8.
15. Bekker HL, Hewison J, Thornton JG. Understanding why decision aids work: linking process with outcome. Patient Educ Couns 2003; 50: 323-9.
16. Lin SC, Tam KW, Yen JYC, Lu MC, Chen EYF, Kuo YT, et al. The impact of shared decision making with patient decision aids on the rotavirus vaccination rate in children: A randomized controlled trial. Prev Med 2020; 141: 106244.
17. Qaseem A, Barry MJ, Denberg TD, Owens DK, Shekelle P. Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med 2013 21; 158: 761-69.
18. Volk R, Llewellyn-Thomas H. The 2012 IPDAS Background Document: An Introduction. In: Volk R, H L-T, eds. Update of the International Patient Decision Aids Standards Collaboration’s Background Document, 2012.
19. Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2017; 4: CD001431.
20. Ghiyasvandian S, Mousavizadeh Sn, 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. Journal of Fasa University of Medical Sciences 2013; 3: 271-9.
21. Eslami S, Aslani A, Tara F, Ghalichi L, Erfanian F, Abu-Hanna A. The impact of a computerized decision aid on empowering pregnant women for choosing vaginal versus cesarean section delivery: study protocol for a randomized controlled trial. Trials 2015; 16: 6- 28.
22. Coronado-Vázquez V, Canet-Fajas C, Delgado-Marroquín MT, Magallón-Botaya R, Romero-Martín M, Gómez-Salgado J. Interventions to facilitate shared decision-making using decision aids with patients in Primary Health Care: A systematic review. Medicine 2020; 99: e21389.
23. Beach MC, Sugarman J. Realizing shared decision making in practice. JAMA 2019; 322: 811-2.
24. Toledo-Chávarri A, Rué M, Codern-Bové N, Carles-Lavila M, Perestelo-Pérez L, Pérez-Lacasta MJ, et al. A qualitative study on a decision aid for breast cancer screening: Views from women and health professionals. Eur J Cancer Care 2017; 26.
25. Agbadje TT, Menear M, Dugas M, Gagnon MP, Rahimi SA, Robitaille H, et al. Pregnant women's views on how to promote the use of a decision aid for Down syndrome prenatal screening: a theory-informed qualitative study. BMC Health Serv Res 2018; 18: 434.
26. Portocarrero ME, Giguère AM, Lépine J, Garvelink MM, Robitaille H, Delanoë A, Lévesque I, Wilson BJ, Rousseau F, Légaré F. Use of a patient decision aid for prenatal screening for Down syndrome: what do pregnant women say? BMC Pregnancy Childbirth 2017; 17: 90.
27. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004; 24(2): 105-12
28. Guba EG, Lincoln YS. Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches: Jossey-Bass; 1981.
29. Baptista S, Heleno B, Pinto M, Guimarães B, China D, Ramos JP, et al. Translation and cultural adaptation of a prostate cancer screening decision aid: a qualitative study in Portugal. BMJ Open 2020; 10: e034384.
30. Alden DL, Friend J, Chun MB. Shared decision making and patient decision aids: knowledge, attitudes, and practices among Hawai'i physicians. Hawaii J Med Public Health 2013; 72: 396-400.
31. Seo J, Goodman MS, Politi M, Blanchard M, Kaphingst KA. Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients. Med Decis Making 2016; 36: 550-6.
32. De Oliveira GS Jr, Errea M, Bialek J, Kendall MC, McCarthy RJ. The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis. BMC Health Serv Res 2018; 18: 958.
33. Garvelink MM, Ter Kuile MM, Stiggelbout AM, De Vries M. Values clarification in a decision aid about fertility preservation: does it add to information provision? BMC Med Inform Decis Mak 2014; 14: 68.
34. Stirling C, Lloyd B, Scott J, Abbey J, Croft T,
Robinson A. A qualitative study of professional and client perspectives on information flows and decision aid use. BMC Med Inform Decis Mak 2012; 12: 26.
35. Berry DL, Halpenny B, Bosco JLF, Bruyere J Jr, Sanda MG. Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men. BMC Med Inform Decis Mak 2015; 15: 56.
36. Sebban C, Browman G, Gafni A, Norman G, Levine M, Assouline D, et al. Design and validation of a bedside decision instrument to elicit a patient’s preference concerning allogenic bone marrow transplantation in chronic myeloid leukemia. Am J Hematol 1995; 48: 221-7.
37. Garvelink MM, ter Kuile MM, Fischer MJ, Louwé LA, Hilders CG, Kroep JR, et al. Development of a Decision Aid about fertility preservation for women with breast cancer in The Netherlands. J Psychosom Obstet Gynaecol 2013; 34: 170-8.
38. Orlando LA, Buchanan AH, Hahn SE, Christianson CA, Powell KP, Skinner CS, Chesnut B, Blach C, Due B, Ginsburg GS, Henrich VC. Development and validation of a primary care-based family health history and decision support program. N C Med J 2013; 74: 287-96.
39. Jull J, Giles A, Lodge M, Boyer Y, Stacey D. Cultural
adaptation of a shared decision making tool with Aboriginal women: a qualitative study. BMC Med Inform Decis Mak 2015; 15: 1.
40. Fatima S, Holbrook A, Schulman S, Park S, Troyan S, Curnew G. Development and validation of a decision aid for choosing among antithrombotic agents for atrial fibrillation. Thromb Res 2016; 145: 143-8.
41. Ng CJ, Mathers N, Bradley A, Colwell B. A ‘combined framework’ approach to developing a patient decision aid: the PANDAs model. BMC Health Services Research 2014; 14: 503.
42. Crothers K, Kross EK, Reisch LM, Shahrir S, Slatore C, Zeliadt SB, et al. Patients' Attitudes Regarding Lung Cancer Screening and Decision Aids. A Survey and Focus Group Study. Ann Am Thorac Soc 2016; 13: 1992-2001.
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IssueVol 14, No 4 (December 2020) QRcode
SectionOriginal Articles
Published2021-02-14
DOI https://doi.org/10.18502/jfrh.v14i4.5205
Keywords
Decision Making Patient Decision Aid (PtDA) Pregnant Women Prenatal Screening

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How to Cite
1.
Zahedi R, Nemati-Anaraki L, Sedghi S, Shariat M. Factors Influencing Pregnant Women’s Use of Patient Decision Aids and Decision Making on Prenatal Screening: A Qualitative Study. J Fam Reprod Health. 14(4):221-228.