The vast majority of physiatrists (91.0%) indicated to use a leaflet or brochure. Handwritten notes also came forward as an often used aid (69.0%). Websites were used by 18%. Decision boards (7%), videos (7%), CD-ROMs (3%) were reported to be used by only a small portion of the respondents.
On the question how often they used one of the decision-aids, the majority of the respondents answered they used it regularly (57%) or often (18%). Eight percent said to never use a decision aid, three percent to use it always.
3.7 Attitude towards decision aids
On the attitude scale for the use of decision aids, most physiatrists showed a moderately positive attitude (mean average score=3.13, SD=0.49). The mean score for each item is shown in Table 7. As the table shows, the strongest agreements were with the assertion that decision aids will cause patients to be more involved in decision-making and the assertion that the majority of patients does not wish to be involved in decision-making.
Table 7. Mean scores on physiatrists’ attitude towards the use decision aids (N=102)
As Table 9 shows, there were significant correlations found between gender and the attitude towards the informed decision-making model. Men showed a higher level of comfort with this approach (M= 3.49, SD=1.19) than women (M=2.96, SD=1.21). No significant correlations were found between gender and levels of comfort with one of the three other approaches.
A significant correlation was found between the level of comfort reported for the informed decision-making approach and the average amount of patients a physiatrist sees in a week. Physiatrists who reported to see more patients in a week, were more likely to report higher levels of comfort with the informed decision-making model.
Physiatrists working primarily with CVA patients or patients with traumatic brain injury reported higher levels of comfort with the paternalistic approach (M=3.00, SD=1.16) than physiatrists working primarily with other groups (M=2.26, SD=1.20). They also reported a higher comfort level with the some sharing approach (M=3.92, SD=0.86) than the physiatrists working with patient groups without cognitive limitation (M=3.26, SD=1.22). Even a significant correlation was found between the diagnose group and the attitude towards the informed approach, with physiatrists working with cognitive limited patients reporting a higher level of comfort with this approach (M=3.56, SD=1.19) than the other physiatrists (M=2.98, SD=1.19). The mean score on the physiatrists attitude towards shared decision-making was lower among physiatrist working with cognitive limited patients (M=4.08, SD=0.91) than among other physiatrists (M=4.30, SD=0.773), though this relationship did not reach significance (p= .342).
To see if the physiatrists working with a cognitive limited patient group also reported to use the approaches for which they reported higher levels of comfort as their common approach to decision-making more often than the group of physiatrists as whole, response frequencies were compared. These comparisons showed that physiatrists working with cognitive limited patients reported to use the paternalistic approach as their common approach more often than the sample as a whole (8.3% versus 3.2%). The informed approach was the most popular (41.7%), the informed approach the least (8.3%). Twenty-nine percent reported the shared decision-making approach to be their usual model for decision-making.
The Pearson correlation coefficients for the relationship between physiatrists’ characteristics and their attitude towards use of decision aid showed no significant correlations. No significant correlations were found between physiatrist’s characteristics and the measure for information provision.
Table 9. Correlations between characteristics of the physiatrists and work setting and their attitude towards several decision-making models and the use of decision aids. (N=102)