Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome.

Area of Science:

• Medical Decision Making
• Patient Education
• Orthopedic Surgery

Background:

• Shared decision-making is key for patient-centered care but can cause decisional conflict.
• Decision aids aim to improve patient understanding and comfort during decision-making.
• Carpal tunnel syndrome (CTS) management involves surgical and non-surgical options.

Purpose of the Study:

• To evaluate if a decision aid reduces decisional conflict in patients with CTS considering surgery.
• To assess the impact of a decision aid on patient knowledge and symptom severity.

Main Methods:

• Eighty patients with CTS were randomized into a test group (decision aid + regular info) and a control group (regular info only).
• The decision aid was a 6-minute video explaining CTS diagnosis, surgery, and alternative treatments.
• Outcomes measured included decisional conflict, knowledge, and symptom severity (Disabilities of Arm, Shoulder, and Hand Questionnaire).

Main Results:

• No significant difference in decisional conflict was observed between the groups (p=0.76).
• The test group demonstrated significantly improved knowledge compared to the control group (p=0.04).
• Less severe symptoms correlated with greater decisional conflict (r=-0.29, p=0.02).

Conclusions:

• Decision aids do not appear to reduce decisional conflict for CTS patients but enhance their knowledge.
• Effective patient education through decision aids is confirmed.
• Emphasizing doctor-patient communication is recommended, particularly for patients with less severe symptoms who may experience higher decisional conflict.