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Nurse-led immunotreatment DEcision Coaching In people with Multiple Sclerosis (DECIMS) - Feasibility testing, pilot
A C Rahn1, S Köpke2, I Backhus3
1Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany.
International Journal of Nursing Studies
|October 7, 2017
Summary
A nurse-led decision coaching program for multiple sclerosis (MS) treatment improved informed choice compared to usual care. This pilot study demonstrates the feasibility and positive reception of empowering nurses in MS treatment decisions.
Area of Science:
- Neurology
- Health Services Research
- Decision Science
Background:
- Treatment decisions for multiple sclerosis (MS) are complex, with limited information typically provided during neurologist appointments.
- The nurse decision coach model was developed to enhance shared decision-making in MS immunotreatment.
Purpose of the Study:
- To assess the feasibility of a nurse-led decision coaching program for MS patients.
- To evaluate recruitment strategies for a larger clinical trial on MS treatment decisions.
Main Methods:
- A pilot randomized controlled trial and mixed-methods process evaluation were conducted at two German MS centers.
- Participants with relapsing-remitting MS received either nurse decision coaching plus an online platform and usual care, or the online platform and usual care.
- Outcomes included 'informed choice,' risk knowledge, treatment attitude, and treatment uptake, assessed via quantitative and qualitative data.
Main Results:
- The pilot study successfully recruited 73% of eligible MS patients.
- The nurse decision coaching intervention resulted in a higher rate of informed choice (48%) compared to the control group (30%) after six months.
- Process evaluation indicated positive acceptance and feasibility of the coaching program among patients, nurses, and physicians.
Conclusions:
- The nurse decision coaching program is feasible, acceptable, and well-received by patients, nurses, and physicians involved in MS care.
- Delegating aspects of immunotreatment decision-making to trained nurses shows potential for improving informed choice and patient participation in MS management.
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