Development And Evaluation Of A Decision Aid For Women With A Breech-presenting Baby.
Funder
National Health and Medical Research Council
Funding Amount
$156,890.00
Summary
Many studies have shown that women want to participate in clinical decisions about the treatments they receive during pregnancy and that involvement in decision making increases satisfaction with maternity care. Decision aids are interventions to help people make specific and deliberative decisions by providing information on the options and outcomes relevant to the person's health. This project aims to develop and evaluate the world's first decision aid for women with a breech presenting baby ( ....Many studies have shown that women want to participate in clinical decisions about the treatments they receive during pregnancy and that involvement in decision making increases satisfaction with maternity care. Decision aids are interventions to help people make specific and deliberative decisions by providing information on the options and outcomes relevant to the person's health. This project aims to develop and evaluate the world's first decision aid for women with a breech presenting baby (bottom rather than head first) in late pregnancy. A decision aid for breech presentation is timely because recent results of an international trial have dramatically altered women's options in the management of breech presentation. The trial of vaginal breech birth versus planned caesarean section (CS) found overwhelming evidence of reduced infant death and disability for women with a planned CS. Planned CS is now considered best practice for delivery of a breech presentation at birth. However, another treatment option for women with a breech presentation is turning the breech to head first before birth (called external cephalic version, ECV). Each of these options (ECV or planned CS) has benefits and risks, and the relative importance of these benefits and risks varies for individual women, a scenario where a decision aid produces the greatest benefit. The breech decision aid developed in this project will be based on the best and most recently available evidence and outcomes. It will incorporate a workbook, audiotape-CD and worksheet that will guide (but not direct) women to a treatment option that best suits them, taking ~20 minutes to complete. The decision aid will be evaluated to assess the impact on women's satisfaction with decision making, knowledge, anxiety and pregnancy outcomes. If successful, the results could be applied to improve consumer information and participation in clinical decisions across a wide spectrum of pregnancy care issues.Read moreRead less
Developing And Measuring Palliative Care Decision Making Skill
Funder
National Health and Medical Research Council
Funding Amount
$137,000.00
Summary
Relationships and communication skills that health professionals develop with patients are critical to patient involvement in decision making. This project will build on previous decision making research and the development of palliative care education for undergraduate students. The key components of successful decision making skills will be investigated and an education program and skill measures for undergraduate and postgraduate health professional students will be developed and pilot tested ....Relationships and communication skills that health professionals develop with patients are critical to patient involvement in decision making. This project will build on previous decision making research and the development of palliative care education for undergraduate students. The key components of successful decision making skills will be investigated and an education program and skill measures for undergraduate and postgraduate health professional students will be developed and pilot tested.Read moreRead less
A Randomised Controlled Trial Of A Decision Aid For The Management Of Pain In Labour And Childbirth
Funder
National Health and Medical Research Council
Funding Amount
$267,375.00
Summary
Many studies have shown that women want to participate in clinical decisions about the treatments they receive during pregnancy and that involvement in decision making increases satisfaction with maternity care. Decision aids are interventions to help people make specific and deliberative decisions by providing information on the options and outcomes relevant to the person's health. This project aims to develop and evaluate the world's first decision aid for women regarding the management of pai ....Many studies have shown that women want to participate in clinical decisions about the treatments they receive during pregnancy and that involvement in decision making increases satisfaction with maternity care. Decision aids are interventions to help people make specific and deliberative decisions by providing information on the options and outcomes relevant to the person's health. This project aims to develop and evaluate the world's first decision aid for women regarding the management of pain in labour and childbirth. A decision aid for managing the pain of childbirth is both practical and timely because there is a strong evidence base on labour analgesia but a lack of evidence-based information for women. For example, brochures on epidural analgesia outline the advantages of epidurals such as complete amelioration of pain, but do not present any information on adverse obstetric outcomes such as the doubling of risk for an instrumental birth. Most women are willing to experience pain in childbirth but do not want pain to overwhelm them. The decision aid will include a range of available drug and non-drug options for pain relief in labour and childbirth. Each of the options has benefits and risks, and the relative importance of these benefits and risks varies for individual women, a scenario where a decision aid produces the greatest benefit. The pain management decision aid developed in this project will be based on the best most recently available evidence and outcomes. It will incorporate a workbook, audiotape-CD and worksheet that will guide (but not direct) women with their pain management options that best suit them, taking ~30 minutes to complete. The decision aid will be evaluated to assess the impact on women's satisfaction with decision making, knowledge, anxiety and pregnancy outcomes. If successful, the results could be applied to improve consumer information and participation in clinical decisions across a wide spectrum of pregnancy care issues.Read moreRead less
Closing The Evidence-practice Gap In Total Knee Replacement: Optimising Evidence-based Decision-making Through A Multi-dimensional Surgeon Feedback Intervention
Funder
National Health and Medical Research Council
Funding Amount
$1,091,926.00
Summary
Total knee replacement (TKR) is one of the most successful surgeries for treating knee arthritis. With an ageing population demand for TKR will increase dramatically, placing burden on our health system. It is estimated that 25% of TKRs are performed in inappropriate candidates according to evidence-based guidelines. This project evaluates a program for surgeons that will improve adherence to using guidelines, which will improve efficiencies & equitability of this important surgical procedure.
A Randomised Controlled Trial Of A Bowel Cancer Screening Decision Aid For Adults With Low Education And Literacy
Funder
National Health and Medical Research Council
Funding Amount
$237,277.00
Summary
The Commonwealth has committed funds for a national bowel cancer screening program. This will involve mailing bowel testing kits direct to eligible consumers at their homes. To minimise inequalities in accessing screening and to ensure effectiveness of the program, information and instructions for testing will have to be accessible to participants from low as well as high educational backgrounds. This project will evaluate communication strategies to achieve this. Reliance on written information ....The Commonwealth has committed funds for a national bowel cancer screening program. This will involve mailing bowel testing kits direct to eligible consumers at their homes. To minimise inequalities in accessing screening and to ensure effectiveness of the program, information and instructions for testing will have to be accessible to participants from low as well as high educational backgrounds. This project will evaluate communication strategies to achieve this. Reliance on written information has rapidly increased within healthcare. In particular, the use of patient decision aids to support and inform health decisions is rapidly increasing. The need to improve information in screening programs has been particularly highlighted and decision aids provide an evidence based approach to achieve this. However, whilst there is level 1 evidence that decision aids improve the decision making process for consumers, research has been carried out almost exclusively among educated participants with high literacy. There is concern that the needs of adults with low education and limited literacy have been ignored. The proposed study is 2 phased. Phase I will test optimal quantitative risk communication formats for adults with low education and literacy. Phase 2 will evaluate a tailored low literacy decision aid for FOBT screening. The trial will test whether the decision aid can increase knowledge of screening, increase involvement in decisions and improve the quality of decision making among adults with low education, and will examine its impact on screening intentions and behaviour. This is a highly significant study. Screening providers need better ways to inform consumers of screening programs that are accessible to a diverse audience and equitable across the target population. This study will have direct implications for use in the national bowel cancer screening program.Read moreRead less