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Birth plans can be used to facilitate shared decision-making in childbirth. A birth plan is a document reflecting women's preferences for birth, which they discuss with their maternity care provider. This scoping review aims to synthesize current findings on the role of birth plans for shared decision-making around birth choices of pregnant women in maternity care. We conducted a scoping review using the Joanna Briggs Institute three-step search strategy in multiple databases PubMed, EMBASE, CINAHL, Web of Science, PsycINFO. We synthesized the results using a metasynthesis approach to identify themes and subthemes. From the 21 articles included, five themes were identified: birth plan as a tool for shared decision-making, autonomy , sense of control , professionalism of the care provider, and trust. Primarily, midwives seemed to use birth plans to explore and facilitate women's choices around birth. Other healthcare providers involved in studies were obstetricians and nurses. The interrelationship between care providers and women, the attitude of care providers and women towards each other and the birth plan, and how providers and women use the birth plan influence shared decision-making. Birth plans can facilitate shared decision-making, and women's sense of autonomy and control before, during, and after giving birth. When discussing the birth plan, exploring different scenarios may help women prepare for unforeseen circumstances. This will likely facilitate shared decision-making even if the birth process is not unfolding as hoped for. [ABSTRACT FROM AUTHOR]

The Autism Spectrum Quotient (AQ) measures autistic traits in children and adults. The adolescent version of the AQ is understudied. We analyzed the factor structure, informant- and sex differences, and clinical utility of the AQ adolescent in 1) parent reports from adolescents in the general population (GenPop; AQ50; N = 465), parent reports from autistic adolescents (Netherlands Autism Register, NAR; AQ28 [Hoekstra et al., 2011]; N = 284), and parent- and self-reports of autistic and non-autistic adolescents (MATCH; AQ50; N = 84). The tested AQ-Adult factor models (Hoekstra et al., 2011; Murray, Allison et al., 2017; Murray, McKenzie et al., 2017; Russell-Smith et al., 2011), showed an acceptable fit in the GenPop sample, and the bi-factor AQ28-Hoekstra (Murray et al., 2011) fitted the NAR sample acceptably. On the AQ28-Hoekstra, autistic adolescents scored lower whereas non-autistic adolescents scored higher than their parents (MATCH), and males scored higher than females on several factors (GenPop, NAR). Moreover, this factor model appeared invariant among autistic and non-autistic groups. Two cut-off scores were evaluated with ROC analyses for parent reports. Given the informant differences, these cannot be applied to self-reports. In conclusion, the AQ28-Hoekstra reliably measures autistic traits in adolescents with and without autism. Combining parent and self-report seems most informative. • · The AQ28-Hoekstra factor structure fits acceptably on general population and autistic adolescent samples. • Autistic adolescents score lower than their parents on the AQ28. • Non-autistic adolescents score higher than their parents on the AQ28. • Male adolescents score higher than female adolescents on several factors of the AQ28. • A cut-off of 65 on the parent report AQ28 adolescent gives 18.5 % false positives, and 7.7 % false negatives. [ABSTRACT FROM AUTHOR]

Background: Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions.Objective: To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure.Methods: We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors.Results: Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments.Conclusions: We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To review the strengths and weaknesses of deliberative and intuitive processes in the context of patient decision support and to discuss implications for decision aid (DA) design. Methods: Conceptual review of the strengths and weaknesses of intuitive and analytical decision making and applying these findings to the practice of DA design. Results: DAs combine several important goals: providing information, helping to clarify treatment related values, supporting preference construction processes, and facilitating more active engagement in decision making. Many DAs encourage patients to approach a decision analytically, without solid theoretical or empirical grounding for this approach. Existing research in other domains suggests that both intuition and deliberation may support decision making. We discuss implications for patient decision support and challenge researchers to determine when combining these processes leads to better outcomes. Conclusions: Intuitive and analytical decision processes may have complementary effects in achieving the desired outcomes of patient decision support. Practice implications: DA developers should be aware that tools solely targeted at supporting deliberation may limit DA effectiveness and harm preference construction processes. Patients may be better served by combined strategies that draw on the strengths and minimize the weaknesses of both deliberative and intuitive processes. [Copyright &y& Elsevier]

Abstract: Healthcare decisions, particularly those involving weighing benefits and harms that may significantly affect quality and/or length of life, should reflect patients'' preferences. To support patients in making choices, patient decision aids and values clarification methods (VCM) in particular have been developed. VCM intend to help patients to determine the aspects of the choices that are important to their selection of a preferred option. Several types of VCM exist. However, they are often designed without clear reference to theory, which makes it difficult for their development to be systematic and internally coherent. Our goal was to provide theory-informed recommendations for the design of VCM. Process theories of decision making specify components of decision processes, thus, identify particular processes that VCM could aim to facilitate. We conducted a review of the MEDLINE and PsycINFO databases and of references to theories included in retrieved papers, to identify process theories of decision making. We selected a theory if (a) it fulfilled criteria for a process theory; (b) provided a coherent description of the whole process of decision making; and (c) empirical evidence supports at least some of its postulates. Four theories met our criteria: Image Theory, Differentiation and Consolidation theory, Parallel Constraint Satisfaction theory, and Fuzzy-trace Theory. Based on these, we propose that VCM should: help optimize mental representations; encourage considering all potentially appropriate options; delay selection of an initially favoured option; facilitate the retrieval of relevant values from memory; facilitate the comparison of options and their attributes; and offer time to decide. In conclusion, our theory-based design recommendations are explicit and transparent, providing an opportunity to test each in a systematic manner. [Copyright &y& Elsevier]

In this study the possible adverse effects of in utero exposure to magnetic resonance (MR) conditions at 1.5 Tesla were examined. Thirty-five children between 1 and 3 years of age, and nine children between 8 and 9 years of age, that were exposed to MR during the third trimester of pregnancy, were checked for possible adverse effects in a follow-up study. Data on pregnancy and birth, the results of a neurological examination at 3 months, their medical documentary with emphasis on eye and ear functioning, and a questionnaire answered by their mothers were collected and evaluated. In five children abnormal test results were observed, that had no relation to the MR exposure. No harmful effects of prenatal MR exposure in the third timester of pregnancy were detected in this study. [Copyright &y& Elsevier]

Abstract: Objective: To investigate the attitude among pregnant women regarding non-invasive prenatal testing (NIPT) for detecting trisomy 21 (T21) and to quantify their willingness to pay for NIPT. Methods: A questionnaire was administered to pregnant women who received counselling for first-trimester screening (FTS) in two hospitals and nine midwife practices in the Netherlands. Results: A total of 147 women completed the questionnaire, yielding a response rate of 43%. If NIPT for detecting T21 were available, 81% stated they would choose to have this test, and 57% of women who elected not to undergo FTS in their current pregnancy would perform NIPT if available. Willingness to pay for NIPT was correlated with age and income, but not education level. The price that participants were willing to pay for NIPT was similar to the current price for FTS. Conclusion: The pregnant women in our study had a positive attitude regarding NIPT for T21, and more than half of the women who rejected prenatal screening would receive NIPT if available. Practice implications: Due to the elimination of iatrogenic miscarriage, caregivers should be aware that informed decision-making can change with respect to prenatal screening with the introduction of NIPT. [Copyright &y& Elsevier]

Objective: To evaluate treatment preferences of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) before and after using a web-based decision aid (DA).Patients and Methods: Between July 2016 and January 2017 patients were invited to use a web-based LUTS/BPH DA. Treatment preferences (for lifestyle advices, medication or surgery) before and after DA use and responses on values clarification exercises were extracted from the DA.Results: In total, 126 patients were included in the analysis. Thirty-four percent (43/126) had not received any previous treatment and were eligible for (continuation of) lifestyle advices or to start medication, as initial treatment. The other 66% (83/126) did use medication and were eligible, either for continuing medication or to undergo surgery. Before being exposed to the DA, 67 patients (53%) were undecided and 59 patients (47%) indicated an initial treatment preference. Half of the patients who were initially undecided were able to indicate a preference after DA use (34/67, 51%). Of those with an initial preference, 80% (47/59) confirmed their initial preference after DA use. Five out of 7 values clarification exercises used in the DA were discriminative between final treatment preferences. In 79%, the treatment preferred after DA use matched the received treatment. Overall, healthcare providers were positive about DA feasibility.Conclusion: Our findings suggest that a LUTS/BPH DA may help patients to confirm their initial treatment preference and support them in forming a treatment preference if they did not have an initial preference. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of including an online decision aid (DA) during prostate cancer treatment counseling on decisional regret and information satisfaction in a one-year follow-up.Methods: Within a cluster RCT, 18 Dutch hospitals were randomized to DA counseling or care-as-usual, patients (n = 382) initially completed questionnaires directly after treatment decision making. Six and twelve months later regret (Decisional Regret Scale) and information satisfaction (SCIP-B) were assessed. Anxious and depressive symptoms (HADS) was included as possible covariate.Results: After 12 months, 43 participants (15%) regretted their treatment choice and 105 participants (36%) were dissatisfied with the information that was received at the time of decision-making, regardless of being exposed to the DA. Anxious and depressive symptoms at follow-up were associated with regret and information dissatisfaction.Conclusion: No long-term benefical effects emerged from DA usage compared to patients who underwent standard counseling.Practice Implications: During PCa treatment counseling, healthcare providers should be aware of anxious and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Implicit associations influence behaviour, but their impact on cancer screening intentions is unknown.Methods: We assessed implicit associations with cervical cancer screening using an evaluative priming task. Participants were shown primes ('Pap test', neutral or non-word) followed by positive or negative target words. The test is based on the assumption that response times are shorter if primes and targets are strongly associated in the participant's mind. The Dutch screening program targets women aged 30-60, 226 of them completed online assessments twice. Prior to the second assessment participants were randomized to reading versus not reading the leaflet about the cervical screening program.Results: After controlling for knowledge and screen history, response times for 'Pap test' no longer differed between positive and negative targets. Implicit associations were not correlated with explicit attitudes or screening intentions. Reading the screening leaflet resulted in improved knowledge levels (p<0.001), but implicit associations, explicit attitudes, and screening intentions remained similar.Conclusion: Cervical cancer screening intentions were related to explicit attitudes, but not to implicit associations. The screening leaflet did not affect screening intentions.Practice Implications: We recommend achieving a deepened interest in the screening program among risk groups, e.g. by adapting the information leaflet. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of a decision aid (DA) on treatment preferences and to investigate which patient preferences are important for final treatment preferences. We also determined if the patient׳s treatment decision was influenced by the urologist׳s treatment preference.Patients and Methods: Between August 2014 and July 2015, newly diagnosed patients with low-/intermediate-risk prostate cancer were offered to use a web-based DA after diagnosis. Treatment preferences and patient׳s values were extracted from the DA. Urologists׳ treatment preferences were indicated at the time of inclusion.Results: We included 181 patients, of whom 21% preferred active surveillance, 33% radical prostatectomy, 10% brachytherapy, 3% external beam radiotherapy, and 34% did not indicate a specific preferred treatment option after DA use (missing N = 6). Among 67%, treatment preference before DA use did not change after DA use. In men who chose active surveillance after DA use, 97% (37/38) preferred to postpone unnecessary treatment. For radical prostatectomy, 91% (52/57) of the patients valued tumor removal, and for brachytherapy, 88% (15/17) valued incontinence worse than bowel complaints. For 64% (missing N = 21) of the patients, urologists indicated one specific preferred treatment option as most suitable for the patient concerned. Agreement between final treatment decision and urologist׳s preference was lower (κ = 0.68) than between final treatment decision and preferred treatment after DA use (κ = 0.82).Conclusion: Most patients with prostate cancer chose the treatment in accordance with the post-DA preference and to a lesser extent the urologists preference; implications of this are prospectively investigated in an ongoing study. [ABSTRACT FROM AUTHOR]

Objective: To investigate decision-making role preferences and their association with the evaluation of information received in a sample of low-risk and intermediate-risk prostate cancer (Pca) survivors.Methods: Cross-sectional study involved 562 men diagnosed with low-risk or intermediate-risk Pca (median time since diagnosis, 48mo), measuring preferred decision-making role (Control Preference Scale) and the evaluation of information received (EORTC QLQ-INFO25). Analyses were performed using analysis of variance, chi-square tests, and multivariable linear regression models.Results: Men who preferred a passive role were older and less educated than other preference groups and more often selected a noninvasive treatment option (all with P<0.001). The passive role preference group reported having received less information, judged the received information as less helpful, and indicated lower overall satisfaction with information received (all with P<0.05). Role preference groups did not differ in their desire to receive more information.Conclusion: Compared with nonpassive preference groups, the preference for a passive role in Pca treatment decision-making is associated with less satisfaction with the information received.Practice Implications: Assessment of role preferences and tailored information provision could improve satisfaction with information received and perhaps may ultimately lead to improved patient participation in treatment decision-making. [ABSTRACT FROM AUTHOR]

Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH).Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identifying patients' needs and expectations, 3: Development of DA content and structure, 4: Usability testing with LUTS/BPH patients.Results: 1 (N=15): Dutch urologists reached consensus on 61% of the statements concerning users' criteria, decision options, structure, and medical content. 2 (N=24): Consensus was reached in 69% on statements concerning the need for improvement of information provision, the need for DA development and that the DA should clarify patients' preferences. 3: DA development based on results from stage 1 and stage 2. 4 (N=10): Pros of the DA were clear information provision, systematic design and easy to read and re-read.Conclusion: A LUTS/BPH DA containing VCEs(**) was developed in cooperation with urologists and patients following a structured 4 stage method and was stated to be well accepted.Practice Implications: This method can be adopted for the development of DAs to support other medical decision issues. [ABSTRACT FROM AUTHOR]