Premium
Involving women in personalised decision‐making on mode of delivery after caesarean section: the development and pilot testing of a patient decision aid
Author(s) -
Schoorel ENC,
Vankan E,
Scheepers HCJ,
Augustijn BCC,
Dirksen CD,
Koning M,
Kuijk SMJ,
Kwee A,
Melman S,
Nijhuis JG,
Aardenburg R,
Boer K,
Hasaart THM,
Mol BWJ,
Nieuwenhuijze M,
Pampus MG,
Roosmalen J,
Roumen FJME,
Vries R,
Wouters MGAJ,
Weijden T,
Hermens RPMG
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12516
Subject(s) - clarity , caesarean section , usability , medicine , multidisciplinary approach , population , scope (computer science) , gynecology , pregnancy , computer science , social science , biochemistry , chemistry , genetics , environmental health , human–computer interaction , sociology , biology , programming language
Objective To develop a patient decision aid (Pt DA ) for mode of delivery after caesarean section that integrates personalised prediction of vaginal birth after caesarean ( VBAC ) with the elicitation of patient preferences and evidence‐based information. Design A Pt DA was developed and pilot tested using the I nternational P atients D ecision A id S tandards ( IPDAS ) criteria. Setting Obstetric health care in the N etherlands. Population A multidisciplinary steering group, an expert panel, and 25 future users of the Pt DA , i.e. women with a previous caesarean section. Methods The development consisted of a construction phase (defini‐tion of scope and purpose, and selection of content, framework, and format) and a pilot testing phase by interview. The process was supervised by a multidisciplinary steering group. Main outcome measures Usability, clarity, and relevance. Results The construction phase resulted in a booklet including unbiased balanced information on mode of birth after caesarean section, a preference elicitation exercise, and tailored risk information, including a prediction model for successful VBAC . During pilot testing, visualisation of risks and clarity formed the main basis for revisions. Pilot testing showed the availability of tailored structured information to be the main factor involving women in decision‐making. The Pt DA meets 39 out of 50 IPDAS criteria (78%): 23 out of 23 criteria for content (100%) and 16 out of 20 criteria for the development process (80%). Criteria for effectiveness ( n = 7) were not evaluated. Conclusions An evidence‐based Pt DA was developed, with the probability of successful VBAC and the availability of structured information as key items. It is likely that the Pt DA enhances the quality of decision‐making on mode of birth after caesarean section.