Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Improving shared decision-making in a clinical obstetric ward by using the three questions intervention, a pilot study

Authors: S. W. E. Baijens, A. G. Huppelschoten, J. Van Dillen, J. W. M. Aarts

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

Shared decision-making (SDM) is an important aspect of modern health care. Many studies evaluated different interventions to improve SDM, however, none in an inpatient clinical setting. A tool that has been proven effective in an outpatient department is the three questions intervention. These questions are created for patients to get optimal information from their medical team and to make an informed medical decision. In this study, we evaluated the feasibility and effectiveness of this simple intervention on SDM in the obstetric inpatient department of a university hospital in the Netherlands.

Method

This is a clinical pilot before and after study, using mixed methods with quantitative and qualitative data collection. The three questions were stated on a card; (i.e. 1) What are my options; 2) What are the possible benefits and harms of those options; 3) How likely are each of those benefits and harms to happen to me?). The study period lasted 6 weeks in which all patients admitted to the obstetric ward were asked to participate in the study. In the first 3 weeks patients did not receive the three questions intervention (pre-intervention group). In the final 3 weeks all patients included received the intervention (intervention group). The main quantitative outcome measure was the level of SDM measured using the SDM-Q9 questionnaire at discharge (range 0–100). In addition, interviews with four patients of the intervention group were conducted and qualitatively analyzed.

Results

Thirty-three patients were included in the pre-intervention group, 29 patients in the intervention group. The mean score of the SDM-Q9 in the pre-intervention group was 65.5 (SD 22.83) and in the intervention group 63.2 (SD 20.21), a not statistically significant difference. In the interviews, patients reported the three questions to be very useful. They used the questions mainly as a prompt and encouragement to ask more specific questions.

Discussion

No difference in SDM was found between the two groups, possibly because of a small sample size. Yet the intervention appeared to be feasible and simple to use in an inpatient department. Further studies are needed to evaluate the impact of implementation of these three questions on a larger scale.
Appendix
Available only for authorised users
Literature
1.
Benbassat J, Pilpel D, Tidhar M. Patients’ preferences for participation in clinical decision making: a review of published surveys. Behav Med. 1998;24(2):81–8.CrossRefPubMed
2.
Boberg EW, Gustafson DH, Hawkins RP, Offord KP, Koch C, Wen KY, et al. Assessing the unmet information, support and care delivery needs of men with prostate cancer. Patient Educ Couns. 2003;49(3):233–42.CrossRefPubMed
3.
Jenkins V, Fallowfield L, Saul J. Information needs of patients with cancer: results from a large study in UK cancer centres. Br J Cancer. 2001;84(1):48.CrossRefPubMedPubMedCentral
4.
van Haastert C, Lekkerkerk T. Meldactie 'Samen beslissen'. Nederlandse Patienten Consumenten Federatie; 2014.
5.
McNair AG, MacKichan F, Donovan J, Brookes S, Avery K, Griffin S, et al. What surgeons tell patients and what patients want to know before major cancer surgery: a qualitative study. BMC Cancer. 2016;16(1):1.CrossRef
6.
7.
Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, Lewin S, Smith RC, Coffey J, Olomu A, Beasley M. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database Syst Rev. 2012;12. Art. No.: CD003267. https://​doi.​org/​10.​1002/​14651858.​CD003267.​pub2.
8.
9.
Shepherd HL, Barratt A, Jones A, Bateson D, Carey K, Trevena LJ, et al. Can consumers learn to ask three questions to improve shared decision making? A feasibility study of the ASK (AskShareKnow) patient–clinician communication model® intervention in a primary health-care setting. Health Expect. 2015;2016;(5):1160–8.
10.
Irwig L, Irwig J, Trevena L, Sweet M. Smart health choices: making sense of health advice. London: Hammersmith Press. Professor Les Irwig, Judy Irwig, Dr Lyndal Trevena, Melissa Sweet; 2008.
11.
Vlemmix F, Warendorf JK, Rosman AN, Kok M, Mol BW, Morris JM, et al. Decision aids to improve informed decision-making in pregnancy care: a systematic review. BJOG. 2013;120(3):257–66.CrossRefPubMed
12.
13.
Durand MA, Carpenter L, Dolan H, Bravo P, Mann M, Bunn F, et al. Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta- analysis. PLoS One. 2014;9(4):e94670.CrossRefPubMedPubMedCentral
14.
Geboortezorg EZI. Zorgstandaard Integrale geboortezorg. 2016 28–06-2016.
15.
Williams AM, Irurita VF. Enhancing the therapeutic potential of hospital environments by increasing the personal control and emotional comfort of hospitalized patients. Appl Nurs Res. 2005;18(1):22–8.CrossRefPubMed
16.
Smith S, Nicol K, Devereux J, Cornbleet M. Encounters with doctors: quantity and quality. Palliat Med. 1999;13(3):217–23.CrossRefPubMed
17.
Marshall A, Kitson A, Zeitz K. Patients' views of patient-centred care: a phenomenological case study in one surgical unit. J Adv Nurs. 2012;68(12):2664–73.CrossRefPubMed
18.
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.CrossRefPubMed
19.
Scholl I, Kriston L, Dirmaier J, Buchholz A, Harter M. Development and psychometric properties of the shared decision making questionnaire--physician version (SDM-Q-doc). Patient Educ Couns. 2012;88(2):284–90.CrossRefPubMed
20.
Kriston L, Scholl I, Holzel L, Simon D, Loh A, Harter M. The 9-item shared decision making questionnaire (SDM-Q-9). Development and psychometric properties in a primary care sample. Patient Educ Couns. 2010;80(1):94–9.CrossRefPubMed
21.
Rodenburg-Vandenbussche S, Pieterse AH, Kroonenberg PM, Scholl I, van der Weijden T, Luyten GP, et al. Dutch translation and psychometric testing of the 9-item shared decision making questionnaire (SDM-Q-9) and shared decision making questionnaire-physician version (SDM-Q-doc) in primary and secondary care. PLoS One. 2015;10(7):e0132158.CrossRefPubMedPubMedCentral
22.
Glass KE, Wills CE, Holloman C, Olson J, Hechmer C, Miller CK, et al. Shared decision making and other variables as correlates of satisfaction with health care decisions in a United States national survey. Patient Educ Couns. 2012;88(1):100–5.CrossRefPubMedPubMedCentral
23.
De las Cuevas C, Perestelo-Perez L, Rivero-Santana A, Cebolla-Marti A, Scholl I, Harter M. Validation of the Spanish version of the 9-item shared decision-making questionnaire. Health Expect. 2015;18(6):2143–53.CrossRefPubMed
24.
Rodriguez-Osorio CA, Dominguez-Cherit G. Medical decision making: paternalism versus patient-centered (autonomous) care. Curr Opin Crit Care. 2008;14(6):708–13.CrossRefPubMed
25.
LaCoursiere SP. A theory of online social support. Adv Nurs Sci. 2001;24(1):60–77.CrossRef
26.
Nussbaum R. Studies of women’s health care: selected results. Perm J. 2000;4(3):62–7.
27.
van Rosse F, de Bruijne M, Suurmond J, Essink-Bot ML, Wagner C. Language barriers and patient safety risks in hospital care. A mixed methods study. Int J Nurs Stud. 2016;54:45–53.CrossRefPubMed
Metadata
Title
Improving shared decision-making in a clinical obstetric ward by using the three questions intervention, a pilot study
Authors
S. W. E. Baijens
A. G. Huppelschoten
J. Van Dillen
J. W. M. Aarts
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1921-z

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue

Research article

Valuing breastfeeding: a qualitative study of women’s experiences of a financial incentive scheme for breastfeeding

Research article

DELAY on first antenatal care visit and its associated factors among pregnant women in public health facilities of Debre Markos town, North West Ethiopia

Research article

Male involvement in maternal health: perspectives of opinion leaders

Research article

Disaster in pregnancy: midwifery continuity positively impacts infant neurodevelopment, QF2011 study

Research article

Comparing barriers to breastfeeding success in the first month for non-overweight and overweight women

Research article

Uptake of intermittent preventive treatment for malaria during pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) among postpartum women in Zomba District, Malawi: a cross-sectional study