Cargando…

Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction

Background: Few studies have addressed patient preferences in emergent surgical decision making. Aim of the study: Analyzing patient preferences for hand trauma reconstruction to propose a decision-making model. Methods: A conjoint analysis survey was developed with Sawtooth Software. Three common f...

Descripción completa

Detalles Bibliográficos
Autores principales: Chang, Dun-Hao, Wang, Yu-Hsiang, Hsieh, Chi-Ying, Chang, Che-Wei, Chang, Ke-Chung, Chen, Yo-Shen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582850/
https://www.ncbi.nlm.nih.gov/pubmed/34769601
http://dx.doi.org/10.3390/ijerph182111081
_version_ 1784597080256282624
author Chang, Dun-Hao
Wang, Yu-Hsiang
Hsieh, Chi-Ying
Chang, Che-Wei
Chang, Ke-Chung
Chen, Yo-Shen
author_facet Chang, Dun-Hao
Wang, Yu-Hsiang
Hsieh, Chi-Ying
Chang, Che-Wei
Chang, Ke-Chung
Chen, Yo-Shen
author_sort Chang, Dun-Hao
collection PubMed
description Background: Few studies have addressed patient preferences in emergent surgical decision making. Aim of the study: Analyzing patient preferences for hand trauma reconstruction to propose a decision-making model. Methods: A conjoint analysis survey was developed with Sawtooth Software. Three common flaps—i.e., a cross-finger flap (CFF), a dorsal metacarpal artery perforator flap (DMAPF), and an arterialized venous flap (AVF)—were listed as treatment alternatives. Five attributes corresponding to these flaps were recovery time, total procedure, postoperative care methods, postoperative scar condition, and complication rate. Utility and importance scores were generated from the software, and preference characteristics were evaluated using cluster analysis. Results: The survey was completed by 197 participants with hand trauma. Complication risk received the highest importance score (42.87%), followed by scar condition (21.55%). Cluster analysis classified the participants as “conservative,” “practical,” and “dual-concern”. The dual-concern and conservative groups had more foreign laborers and highly educated participants, respectively, than the other groups. Most participants in the conservative and practical groups preferred DMAPF, whereas those in the dual-concern group favored CFF. Our proposed model consisted of shared decision-making and treatment recommendation pathways. Conclusion: Incorporating patient preferences into the decision-making model can strengthen patient-centered care. Further research on the applications of the proposed model is warranted.
format Online
Article
Text
id pubmed-8582850
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-85828502021-11-12 Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction Chang, Dun-Hao Wang, Yu-Hsiang Hsieh, Chi-Ying Chang, Che-Wei Chang, Ke-Chung Chen, Yo-Shen Int J Environ Res Public Health Article Background: Few studies have addressed patient preferences in emergent surgical decision making. Aim of the study: Analyzing patient preferences for hand trauma reconstruction to propose a decision-making model. Methods: A conjoint analysis survey was developed with Sawtooth Software. Three common flaps—i.e., a cross-finger flap (CFF), a dorsal metacarpal artery perforator flap (DMAPF), and an arterialized venous flap (AVF)—were listed as treatment alternatives. Five attributes corresponding to these flaps were recovery time, total procedure, postoperative care methods, postoperative scar condition, and complication rate. Utility and importance scores were generated from the software, and preference characteristics were evaluated using cluster analysis. Results: The survey was completed by 197 participants with hand trauma. Complication risk received the highest importance score (42.87%), followed by scar condition (21.55%). Cluster analysis classified the participants as “conservative,” “practical,” and “dual-concern”. The dual-concern and conservative groups had more foreign laborers and highly educated participants, respectively, than the other groups. Most participants in the conservative and practical groups preferred DMAPF, whereas those in the dual-concern group favored CFF. Our proposed model consisted of shared decision-making and treatment recommendation pathways. Conclusion: Incorporating patient preferences into the decision-making model can strengthen patient-centered care. Further research on the applications of the proposed model is warranted. MDPI 2021-10-21 /pmc/articles/PMC8582850/ /pubmed/34769601 http://dx.doi.org/10.3390/ijerph182111081 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chang, Dun-Hao
Wang, Yu-Hsiang
Hsieh, Chi-Ying
Chang, Che-Wei
Chang, Ke-Chung
Chen, Yo-Shen
Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction
title Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction
title_full Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction
title_fullStr Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction
title_full_unstemmed Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction
title_short Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction
title_sort incorporating patient preferences into a decision-making model of hand trauma reconstruction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582850/
https://www.ncbi.nlm.nih.gov/pubmed/34769601
http://dx.doi.org/10.3390/ijerph182111081
work_keys_str_mv AT changdunhao incorporatingpatientpreferencesintoadecisionmakingmodelofhandtraumareconstruction
AT wangyuhsiang incorporatingpatientpreferencesintoadecisionmakingmodelofhandtraumareconstruction
AT hsiehchiying incorporatingpatientpreferencesintoadecisionmakingmodelofhandtraumareconstruction
AT changchewei incorporatingpatientpreferencesintoadecisionmakingmodelofhandtraumareconstruction
AT changkechung incorporatingpatientpreferencesintoadecisionmakingmodelofhandtraumareconstruction
AT chenyoshen incorporatingpatientpreferencesintoadecisionmakingmodelofhandtraumareconstruction