Patient Preference and Adherence (Sep 2022)

Development and Pilot-Testing of a Patient Decision-Making Aid for Nutrition in Age-Related Macular Degeneration

  • Guo W,
  • Wan J,
  • Zhang F,
  • Liu M,
  • Tan M,
  • Bian W

Journal volume & issue
Vol. Volume 16
pp. 2567 – 2577

Abstract

Read online

Wenmei Guo,1,2 Junli Wan,1,2 Feng Zhang,1,2 Mingqiong Liu,1,2 Mingqiong Tan,1,2 Wei Bian1,2 1Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China; 2Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, People’s Republic of ChinaCorrespondence: Wei Bian, Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, People’s Republic of China, Tel +8615922933012, Email [email protected]: We described the development and pilot-testing of an application based patient decision-making aid (PDA) for nutrition in age-related macular degeneration (AMD). Alpha-testing and beta-testing were performed to explore the PDA’s usability, acceptability, and comprehensibility in the design stage and in “real-life” conditions.Methods: A nutrition PDA was developed in this study by a multidisciplinary steering committee that consisted of ophthalmologists, nurses, nutritionists, and methodologists using a systematic development process. The PDA was based on a smartphone native installation and a free-to-use app. First, based on information from literature reviews and focus group interviews for needs assessment, we developed a decision aid prototype. Second, we conducted the alpha testing to explore the acceptability, usability, and comprehensibility of the PDA prototype among 18 AMD patients. Third, a before/after study was conducted to assess changes in the attitudes, risk perceptions, intentions, knowledge, decisional conflicts, and decision self-efficacy of 33 AMD patients.Results: The alpha test proved that the nutrition PDA is acceptable and usable. In the beta test, after the AMD participants used the PDA, their scores for knowledge [mean = 13.3, standard deviation (SD) = 2.92], attitude (mean = 18.97, SD = 2.19), decision self-efficacy (mean = 23.94, SD = 6.04), and preparation significantly increased (mean = 26.30, SD = 4.90), and their score for decisional conflict significantly decreased (mean = 10.15, SD = 3.66). There was no significant difference in anxiety (mean = 2.64, SD = 1.08) before and after the use of the PDA. The mean score in the system usability scale was above 70 (mean = 72.61; SD = 5.38), which indicates the good usability of the PDA. With regard to the PDA acceptability, the scores for satisfaction with its comprehensibility, satisfaction with its attractiveness, and satisfaction with its emotional support were 5.49 (SD = 1.03), 5.30 (SD = 1.40), and 4.91(SD = 1.07), respectively, which show its adequate acceptability.Conclusion: Our study showed that the nutrition PDA was an acceptable and suitable instrument for AMD patients and fit the values of all its stakeholders. This study is an important step in supporting shared decision-making, which has the potential to provide a more patient-centered and value-based nutrition health system for individuals with different types of AMD.Keywords: age-related macular degeneration, nutrition, decision-making aid

Keywords