TY -的AU - Yu,凯瑟琳AU -崔,多萝西AU -布鲁诺,Brigida走非盟-索普,凯文·E AU -施特劳斯,沙龙E盟——Cantarutti保罗盟——楚,凯伦盟——Frydrych保罗盟——Hoang-Kim艾米AU - iver,挪亚盟-卡普兰,大卫盟——梁、Fok-Han盟——马克,约翰AU - Rezmovitz,杰里米非盟——销售,乔安娜盟——Sodhi-Helou苏密特盟——斯泰西,黎明盟——Telner迪安娜PY - 2020 DA - 2020/9/30 MyDiabetesPlan TI -的影响,基于web的病人决定援助决策冲突,糖尿病患者的糖尿病困扰、生活质量和慢性疾病护理:聚类随机对照试验JO - J Med Internet Res SP - e16984 VL - 22 IS - 9kw -共同决策KW -护理目标KW -决策辅助KW -糖尿病KW -决策冲突KW -生活质量KW -慢性疾病护理患者评估KW -糖尿病困扰KW -随机临床试验AB -背景:以人为本的护理对于提供高质量的糖尿病护理至关重要。共同决策(SDM)是以人为本的护理的核心，在糖尿病护理中，它可以提高决策质量、患者知识和患者风险感知。提供以人为本的护理可以促进使用患者决策辅助(ptda)。我们开发了MyDiabetesPlan，这是一个交互式SDM和目标设定PtDA，旨在帮助个性化护理优先级，并支持SDM的跨专业方法。目的:本研究旨在评估“我的糖尿病计划”对决策冲突、糖尿病困扰、健康相关生活质量和患者对个体水平慢性疾病护理评估的影响。方法:一项两步、平行、10个站点的随机对照试验(第一步:仅由提供者指导实施;第二步:以提供者和患者为导向实施(6个月后)。参与者是来自安大略省西南部10个家庭健康小组(FHTs)的18岁及以上患有糖尿病和其他两种合并症的成年人。 FHTs were randomly assigned to MyDiabetesPlan (n=5) or control (n=5) through a computer-generated algorithm. MyDiabetesPlan was integrated into intervention practices, and clinicians (first step) followed by patients (second step) were trained on its use. Control participants received static generic Diabetes Canada resources. Patients were not blinded. Participants completed validated questionnaires at baseline, 6 months, and 12 months. The primary outcome at the individual patient level was decisional conflict; secondary outcomes were diabetes distress, health-related quality of life, chronic illness care, and clinician intention to practice interprofessional SDM. Multilevel hierarchical regression models were used. Results: At the end of the study, the intervention group (5 clusters, n=111) had a modest reduction in total decisional conflicts compared with the control group (5 clusters, n=102; −3.5, 95% CI −7.4 to 0.42). Although there was no difference in diabetes distress or health-related quality of life, there was an increase in patient assessment of chronic illness care (0.7, 95% CI 0.4 to 1.0). Conclusions: Use of goal-setting decision aids modestly improved decision quality and chronic illness care but not quality of life. Our findings may be due to a gap between goal setting and attainment, suggesting a role for optimizing patient engagement and behavioral support. The next steps include clarifying the mechanisms by which decision aids impact outcomes and revising MyDiabetesPlan and its delivery. Trial Registration: ClinicalTrials.gov NCT02379078; https://clinicaltrials.gov/ct2/show/NCT02379078 SN - 1438-8871 UR - //www.mybigtv.com/2020/9/e16984/ UR - https://doi.org/10.2196/16984 UR - http://www.ncbi.nlm.nih.gov/pubmed/32996893 DO - 10.2196/16984 ID - info:doi/10.2196/16984 ER -