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305 The outcome of sharing decision-making in post-acute stage stroke patients who plan to receive rehabilitation program
  1. Ying-Ru Li,
  2. Yu-Ying Chen,
  3. Shu-Chin Hsu,
  4. Yi-Ling Lin,
  5. Hsiu-Yun Liu
  1. Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan

Abstract

Introduction In Taiwan, stroke patients are initially treated at medical centers, but they would require extended rehabilitation after the acute stage. The rehabilitation model includes inpatient, post-acute care (PAC), and outpatient services. This study aimed to explore the outcome of Patient Decision Aids (PDA) for shared decision-making (SDM) of rehabilitation after stroke.

Methods From 2020 to 2022, we included patients in the post-acute phase of acute stroke, specifically in neurosurgery and neurology wards. The steps of Choice Talk, Option Talk, and Decision Talk of SDM were implemented. The efficacy was analyzed by the revised questionnaire developed by the Joint Commission of Taiwan, during this Shared Decision Making (SDM) process, which measured if the family had a better understanding of the choices and was more likely to agree with the related plans without anxiety.

Results A total of 133 patients received SDM in this study; for the final services, they chose different models, PAC service, inpatient rehabilitation, and Outpatient Rehabilitation, 47, 37, and 9, respectively. Additionally, 40 individuals could not make an immediate decision regarding their rehabilitation model. The average satisfaction scores of efficacies increased from 3.17 to 4.17 (total = 5). From the following up, there were 58 transferred to PAC, 46 Inpatient Rehabilitation, 25 returning home, and three transferring to institutions, one expired. The choice different from their initial decision was 18%.

Discussion With the process of SDM by PDA, patients could choose their preferred and valuable rehabilitation plan. But, there still were different choices between before and after SDM. The findings consisted of the related studies of literature review.

Conclusion(s) This study suggested the benefit of SDM and PDA for patients in making medical decisions. Further investigation was suggested to find out factors that might cause the different choices between the before and after SDM.

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