Semester

Summer

Date of Graduation

2007

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Barry Edelstein

Abstract

Decision aids for treatment selection have improved the decision-making process by increasing patient knowledge, decreasing decisional conflict (or uncertainty), increasing strength of preference for an option, and increasing decision satisfaction. Decision aids provide information and assist patients in making informed medical decisions. Guided decision aids help patients weigh pros and cons of options. This study involved the creation and evaluation of a guided decision aid for patients with follicular lymphoma, a disease with multiple complex treatment options. The aid was evaluated in a non-patient sample (30 males and 30 females, aged 40 to 79). Participants received either the guided decision aid or a comparison decision aid. Participants were asked to make a decision as if they were patients with follicular lymphoma by rating preference for each option and rank ordering treatment options before and after reading the materials. Decision satisfaction, decisional conflict, and knowledge of follicular lymphoma were assessed before and after reading the materials. Both groups showed a comparable increase in decision satisfaction, decrease in decisional conflict, and increase in knowledge after reading the materials. Thus, the decision aid was effective in improving the decision-making process. Both groups showed a change in preference for treatment options when rating treatment preference; however, only the comparison group showed a change in treatment preference when treatments were rank-ordered. Preference increased for watch and wait and biologic therapy and decreased for stem cell transplantation. The extent to which age, education, gender, depression, anxiety, need for cognition, and monitory/blunting predicted variability in satisfaction with decision and decisional conflict was examined. There were no significant predictors of residualized change in decision satisfaction; however, age significantly predicted residualized change in decisional conflict, and younger participants showed a decrease in decisional conflict. Analysis of the extent to which reading time and decision-making time predicted residualized change in knowledge suggested that longer reading times showed an increase in knowledge. These findings suggest that receiving information about follicular lymphoma effectively improved the decisionmaking process for a non-patient sample regardless of whether treatment preference changed. Additionally, the findings suggest that the guided decision aid may be more effective for younger ages.

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