title: Feasibility of web-based decision aids in neurological patients.
abstract: Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of arm-hand function in cervical spinal cord injury (SCI). Data collection comprised a telephone interview and a self-reported paper questionnaire. Of the patients who agreed to participate, 39 stroke patients (44%) and 38 patients with SCI (78%) returned a questionnaire. More than 75% of patients expressed a need for more information about the treatment of disease-related impairment. The DAs were highly appreciated by both patient groups. Nearly all patients expressed a positive attitude towards the use of the web-based DAs in general practice. The DAs had a positive effect on the knowledge about the treatment alternatives in the stroke patients (P = 0.001), although not in the patients with SCI. The DAs reduced patients' conflict about treatment (P < 0.05). The effect of the DAs on patients' desired role in decision-making was limited. Web-based aids are feasible in the rehabilitation population with access to a computer and can improve the knowledge gaps in patients.
authors.affiliation: Health Technology and Services Research, University of Twente, Enschede, The Netherlands. j.a.vantil@utwente.nl
authors.forename: Janine A
authors.initials: JA
authors.lastname: van Til
authors.forename: Constance H C
authors.initials: CH
authors.lastname: Drossaert
authors.forename: Gerbert J
authors.initials: GJ
authors.lastname: Renzenbrink
authors.forename: Govert J
authors.initials: GJ
authors.lastname: Snoek
authors.forename: Evelien
authors.initials: E
authors.lastname: Dijkstra
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stiggelbout
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Ijzerman
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002574:Cervical Vertebrae; D003657:Decision Making; D003661:Decision Support Techniques; D005121:Extremities / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods; D015397:Program Evaluation; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires