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Predicting decisional conflict: Anxiety and depression in shared decision making
Anja K Köther1, Georg W Alpers1, Björn Büdenbender1
1Chair of Clinical and Biological Psychology and Psychotherapy, Department of Psychology, School of Social Sciences, University of Mannheim, Germany.
Patient Education and Counseling
|November 29, 2020
Summary
Emotional distress, including anxiety and depression, is common in urology patients. This distress significantly predicts decisional conflict after medical consultations, impacting shared decision making (SDM).
Area of Science:
- Urology
- Psychological Medicine
- Healthcare Research
Background:
- Emotional distress is often overlooked in medical consultations, despite its potential to hinder shared decision making (SDM).
- Systematic assessment of patient affect is not standard practice in many clinical settings.
Purpose of the Study:
- To investigate the prevalence of anxiety and depression in urological outpatients before consultations.
- To determine if pre-consultation emotional distress predicts post-consultation decisional conflict.
Main Methods:
- A cohort of 397 urological outpatients (42% oncological) completed the Hospital Anxiety and Depression Scale pre-consultation.
- Patients then completed the Decisional Conflict Scale post-consultation.
- Multiple regression analysis was used to assess the predictive relationship between emotional distress and decisional conflict.
Main Results:
- Approximately 25% of patients reported clinically significant emotional distress.
- Pre-consultation emotional distress was a significant predictor of higher decisional conflict.
- No significant differences in emotional distress were observed between oncological and non-oncological urology patients.
Conclusions:
- Emotional distress is prevalent among both oncological and non-oncological urology patients.
- Pre-consultation emotional distress is a key factor influencing decisional conflict following physician consultations.
- Systematic assessment of emotional distress in clinical practice could enhance SDM processes and outcomes.
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