gms | German Medical Science

Objectives/Interrogation: Although a shared decision-making model is emphasized for patient-centered care, patients experiencing acute trauma might have limited time and resource for their involvement in decision-making, which may lead to decisional conflict. The purpose of this study was to evaluate whether a decision aid can reduce decisional conflict in patients undergoing plate fixation for a distal radius fracture (DRF) and to investigate factors that may affect the decisional conflict.

Methods: We prospectively enrolled 50 patients who presented with acute DRF and chose to undergo plate fixation. We randomized these patients into two groups. The test group was given a decision aid in addition to regular information while the control group was only given regular information. The decision aid consisted of purpose, procedure, and effect of the surgery, precautions and complications after the operation, and other treatment options that could be performed if operation was not performed. At 2 weeks after the surgery, we evaluated patients' decisional conflict during decision-making for surgery by decisional conflict scale (DCS). In addition, we evaluated factors that might affect decisional conflict, such as age, dominant hand, comorbidities, history of previous surgeries, perceived disability, and administration of a decision aid.

Results and Conclusions: The test group showed significantly lower DCS than the control group (19.6 vs. 32.1, P = 0.001). In multivariate analysis for factors affecting the DCS, younger age and administration of a decision aid were independently associated with lower DCS.

This study shows encouraging results towards that a decision aid can reduce decisional conflict in patients undergoing plate fixation for DRF. This study also shows encouraging results towards that older patients have more decisional conflict in decision-making for surgery than younger patients, suggesting that they need more careful doctor-patient communication.