Annotated bibliography: studies evaluating decision-support interventions for patients.
Explore the source record for details and available documents.
Decision Making↗
Biomedical subjects
E R Drake
Publications and source records attributed to E R Drake.
Electronic fetal monitoring: a Canadian survey.
OBJECTIVES: To determine the current status of electronic fetal monitoring (EFM) in Canadian teaching and nonteaching hospitals, to review the medical and nursing standards of practice for EFM and to determine the availability of EFM educational programs. DESIGN: National survey in 1989. PARTICIPANTS: The directors of nursing at the 737 hospitals providing obstetric care were sent a questionnaire and asked to have it completed by the most appropriate staff member. The response rate was 80.5% (593/737); 44 hospitals did not have deliveries in 1988 and were excluded. The remaining hospitals varied in size from 8 to 1800 (mean 162.1) beds and had 1 to 7500 (mean 617.1) births in 1988; 18.8% were teaching hospitals. RESULTS: Of the 549 hospitals 419 (76.3%) reported having at least 1 monitor (range 1 to 30; mean 2.6); the mean number of monitors per hospital was higher in the teaching hospitals than in the nonteaching hospitals (6.2 v. 1.7). Manitoba had the lowest mean number of monitors per hospital (1.1) and Ontario the highest (3.7). In 71.8% of the hospitals with monitors almost all of the obstetric patients were monitored at some point during labour. However, 21.6% of the hospitals with monitors had no policy on EFM practice. The availability of EFM educational programs for physicians and nurses varied according to hospital size, type and region. CONCLUSIONS: Most Canadian hospitals providing obstetric services have electronic fetal monitors and use them frequently. Although substantial research has questioned the benefits of EFM, further definitive research is required. In the meantime, a national committee should be established to develop multidisciplinary guidelines for intrapartum fetal assessment.
Canada↗
Soft drug use after pregnancy compared to use before and during pregnancy.
With the use of information gathered through the course of pregnancy and data collected after delivery, the changing patterns of alcohol, nicotine, and marijuana use of 288 women participating in the Ottawa Prenatal Prospective Study were investigated. The time periods considered were the year before pregnancy, each trimester of pregnancy, and 1, 6, and 12 months post partum. Alcohol use showed the most marked reduction of the three drugs during pregnancy, but a year after delivery prepregnancy drinking patterns (including binging) had been reestablished. An exception to this was a continued reduction of alcohol consumption by those categorized as heavy social drinkers prior to pregnancy. Although not as marked as the alcohol reduction, nicotine use was reduced during pregnancy and continued to remain at the reduced level 1 year post partum. Heavy marijuana use was the least reduced of the drugs during pregnancy and consumption returned to prepregnancy levels a year after the birth of the baby.
Alcohol Drinking↗
The Ottawa patient decision aids.
CONTEXT: Shared decision-making programs, or patient decision aids, have been developed for difficult decisions in which patients need to consider benefits versus risks. PRACTICE PATTERN EXAMINED: Decision aids currently used in practice in Ottawa, Ontario, Canada. DATA SOURCES: Published studies of patients faced with decisions about hormone therapy, prenatal testing, lung cancer treatments, and anticoagulation for atrial fibrillation; administrative data on distribution of decision aids; and a survey mailed to pulmonologists and surgeons. RESULTS: Although most patients considering health care options arrive for counseling with strong predispositions toward a particular option, some are uncertain about their choice and express the need for information, clarification of values, and advice about their options. Decision aids prepare patients for decision making by increasing their knowledge about expected outcomes and personal values. The aids are used in our local centers, and more than 6000 kits have been distributed in Canada, the United States, Europe, and Australia. They primarily affect the decisions of patients who are undecided at baseline and sometimes reduce the proportion of patients who choose more intensive options. CONCLUSION: The Ottawa patient decision aids assist patient decision making, particularly among those who are undecided.
Adult↗
Evaluation of the "Time to Quit" self-help smoking cessation program.
Public health and hospital nurses have widespread contact with smokers; an effective smoking cessation program administered by nurses has tremendous potential. This study evaluated: 1) the effectiveness of the self-help cessation program, "Time to Quit"/"Moi aussi, j'écrase" (TTQ), provided on a one-to-one basis; and 2) a smoking cessation training program for baccalaureate nursing students. Nursing students recruited 307 smokers who were randomly assigned to receive one of two interventions. Control smokers received a list of community smoking cessation resources and experimental subjects received this list plus TTQ. Smoking self-reports and cotinine levels were obtained at baseline, six weeks and nine months. More smokers receiving TTQ had reduced at six weeks post-intervention, while there were no differences in quit or reduction rates at the nine-month follow-up. Students were positive about learning the techniques and their knowledge scores were significantly higher than those of non-participating students.
Adult↗
Factors influencing the acceptance of hepatitis B vaccine by students in health disciplines in Ottawa.
Few students in health care disciplines are immunized against hepatitis B. In order to determine the immunization prevalence and identify the factors influencing the intentions of students to accept hepatitis B vaccine, we administered a questionnaire to 435 university and community college students in health care disciplines in Ottawa where there was no hepatitis B immunization program. We found that only 14% of the students had been immunized. There was significant variability among student groups in their perceptions of the risk of acquiring hepatitis B, beliefs about the efficacy of the vaccine, and their willingness to pay for it. The need for a low-cost vaccine was demonstrated by the fact that only 35% of students would pay the wholesale price of the vaccine ($100), but 94% said they would pay $15.
Canada↗