PubMed Health⌕ Search

Biomedical subjects

Jim G Thornton

Publications and source records attributed to Jim G Thornton.

5 recordsLinked to original sources
PubMed2004

A randomised trial of photographic reinforcement during postoperative counselling after diagnostic laparoscopy for pelvic pain.

OBJECTIVE: To measure the effect of seeing a photograph of the pelvic findings at laparoscopy. SETTING: Two university teaching hospitals. METHOD: A randomised-controlled trial. SUBJECTS: Two hundred thirty-three women undergoing diagnostic laparoscopy for the investigation of chronic pelvic pain. INTERVENTIONS: At operation a Polaroid print was taken of the pelvis. If this was of satisfactory quality, the patient was randomly allocated to either see, or not see, the print during the postoperative consultation. MAIN OUTCOMES: Pain severity and pain belief scores at 3 and 6 months. ANALYSIS: By intention to treat. RESULTS: Postoperative consultations with photographs did not improve immediate understanding and satisfaction with the consultation. In addition, compared to controls, both patients and doctors did not perceive particular benefit for communication from the photograph. There was a consistent trend to more pain in the photographic reinforcement group and more negative pain beliefs. At 3 months, the average within person differences showed some benefit in visual analogue pain scores, McGill affect scores, 'permanence' and 'self-blame' scores. These benefits were not statistically significant. At 6 months, there was a consistent pattern of benefit from pain severity and pain beliefs, again these benefits were not statistically significant. CONCLUSION: No clear benefits result from showing patients photographs of their pelvis.

Adult↗
PubMed2004

Applying decision analysis to facilitate informed decision making about prenatal diagnosis for Down syndrome: a randomised controlled trial.

OBJECTIVE: To evaluate decision analysis as a technique to facilitate women's decision-making about prenatal diagnosis for Down syndrome using measures of effective decision-making. DESIGN: Randomised controlled trial in a UK hospital's prenatal diagnosis clinic. INTERVENTION: Routine versus routine consultation structured by decision analysis. PARTICIPANTS: 117/132 women receiving a screen-positive maternal serum screening result participated (58 routine, 59 decision analysis). METHODS: Consultations were audio tape-recorded, transcribed and coded; questionnaires were completed after the consultation and one month later after receipt of a diagnostic test and/or the 19-week scan result. MAIN MEASURES: Test decision, subjective expected utilities, knowledge, informed decision-making, risk perception, decisional conflict, anxiety, perceived usefulness and directiveness of consultation information. RESULTS: 48/59 in the decision-aided group and 47/58 in the routine group underwent prenatal diagnosis. Informed decision-making was higher, perceived risk more realistic and decisional conflict over time lower in the decision analysis group. Decision analysis had no impact on knowledge or SEU scores, and was no more or no less directive, useful or anxiety provoking than the routine care. Consultations were six minutes longer. CONCLUSIONS: Decision analysis consultations enable women to make more informed prenatal diagnosis decisions. Professionals will need training to use this technique effectively.

Anxiety↗
PubMed2003

Understanding why decision aids work: linking process with outcome.

Decision aids help patients make treatment choices. There is little empirical evidence to explain how they work. The results from this randomised controlled trial comparing routine with decision-aided consultations in the prenatal diagnosis for Down's syndrome context are used to describe the strategies employed during decision making, to assess the impact of a decision aid on decision processes, and to investigate decision process and outcome associations. Data were elicited from two content analyses of consultation transcripts and questionnaires assessing knowledge, anxiety, decisional conflict, reasons, and information usefulness. 68/106 women completed measures at consultation and follow-up. Decision-aided women employed more cognitive and emotional strategies during decision making. More negative evaluations during decision making were associated with better outcomes. Decision-aided consultations facilitated the employment of strategies associated with more effective choices. These consultations take longer and elicit greater expressions of negative affect, so may be less rewarding encounters for health professionals.

Adult↗
PubMed2003

Choices about abortion method: assessing the quality of patient information leaflets in England and Wales.

OBJECTIVE: To assess the quality of patient leaflets regarding the choice between medical and surgical abortions. DESIGN: Cross sectional survey. SETTING: NHS and private providers of abortion services in England and Wales. SAMPLE: Leaflets from three private providers, all teaching hospitals (n = 14) and a representative sample of NHS district hospitals (n = 27), accessed by approximately 100,000 women per year. METHODS: On telephoning the above abortion services, the leaflets provided to women choosing to have medical or surgical abortions were requested. Content analysis of leaflets included: application of a coding frame assessing adequacy of information about options, risks and procedures; the Flesch Readability Ease scale. MAIN OUTCOME MEASURES: Provision of leaflet, adequacy of information and ease of readability. RESULTS: Seventy-three percent (44/60) of contacted providers offered women a leaflet. Of these 44 leaflets, one mentioned medical and 15 surgical abortion methods only. Adequacy of information provision was low, with on average 10/23 points covered about the surgical method, 12/21 points about the medical method and 7/11 points about aftercare. Readability scores were poor with 24/44 (55%) rated as 'difficult' or 'fairly difficult'. Among NHS providers, scores were slightly higher in the teaching than in the district hospitals. CONCLUSIONS: On average, leaflets provided half the information possible about the risks and procedures of medical and surgical methods. In addition, readability was rated as difficult in over half the leaflets. It seems unlikely that these leaflets enable women to make informed choices between abortion methods and, therefore, do not meet the requirements of current guidelines.

Abortion, Induced↗