Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome.
Although a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery.



Eighty patients with CTS were randomized into two groups. The test group was given a decision aid in addition to regular information and the control group regular information only. The decision aid consisted of a 6-min videoclip that explains diagnosis and information regarding surgery for CTS with other treatment options. We evaluated patients' decisional conflict regarding surgery, knowledge about CTS, and symptom severity as measured by the Disabilities of Arm, Shoulder, and Hand (DASH) Questionnaire.



There was no difference in the decisional conflict scale (DCS) between both groups (p = 0.76). The test group had significantly better knowledge than the control group (p = 0.04). There was no correlation between the knowledge score and the DCS (p = 0.76). However, less severe symptoms were correlated with greater decisional conflict (r = -0.29, p = 0.02).



We found that a decision aid does not reduce decisional conflict in patients with CTS, although it can help them be better informed. This study suggests that although a decision-aid is effective for patient education, doctor-patient communication should be more emphasized for patients with less severe symptoms, as they can have greater decisional conflict.



SNUBH Registry 1510/317-003 Registered November 13, 2015.
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. hsgong@snu.ac.kr.
Hyun Sik
HS
Gong
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Jin Woo
JW
Park
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Young Ho
YH
Shin
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Kahyun
K
Kim
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Kwan Jae
KJ
Cho
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Goo Hyun
GH
Baek
D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D002755:Choice Behavior; D000066491:Clinical Decision-Making; D003220:Conflict, Psychological; D003661:Decision Support Techniques; D004185:Disability Evaluation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D056910:Republic of Korea; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014741:Video Recording
Carpal tunnel syndrome; Decision aid; Decisional conflict; Knowledge