Navigating decisional conflict: laser peripheral iridotomy for primary angle-closure glaucoma prevention

To investigate decisional conflict among patients diagnosed with primary angle-closure suspect (PACS) or primary angle-closure (PAC) who are considering laser peripheral iridotomy (LPI) treatment.

A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023. These participants then completed a general information questionnaire and the Decision Conflict Scale. Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.

The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01, with 99.1% of these individuals reporting experiencing decisional conflict. Multiple linear regression analysis revealed that females (P=0.002) and patients with a shorter duration of the disease (P=0.006) had higher levels of decisional conflict. Additionally, patients diagnosed during medical visits (P=0.049), those who refused LPI treatment (P=0.032), and individuals facing significant economic burdens related to medical expenses (P=0.005) exhibited higher levels of decisional conflict. Furthermore, patients who preferred to make medical decisions independently (P=0.023) and those who favored involving family members in decision-making (P=0.005) experienced increased levels of decisional conflict.

Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict. Healthcare professionals should thoroughly assess a range of factors that influence this conflict, including gender, duration of disease, method of diagnosis acquisition, LPI treatment, economic burden of medical expenses, and patient preferences regarding medical decision-making. By considering these variables, tailored decision support can be developed to address individual patient needs, ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.