Decisional conflict in surgical patients: Should surgeons care?

Mélissa Roy; Christine B. Novak; David R. Urbach; Steven J. McCabe; Herbert P. von Schroeder; Karen Okrainec

Decisional conflict in surgical patients: Should surgeons care?

Can J Surg. 2019 Mar 22;62(3):1-3. Online ahead of print.

Authors

Mélissa Roy¹, Christine B. Novak¹, David R. Urbach¹, Steven J. McCabe¹, Herbert P. von Schroeder¹, Karen Okrainec¹

Affiliation

¹ From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Roy, Novak, McCabe, Schroeder); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Roy, Urbach, Okrainec); the Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Urbach); and the Division of Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ont. (Okrainec).

PMID: 30900439

Abstract

Decisional conflict represents a state of uncertainty regarding an action one must take. It is a concept inherent to shared decision-making and can help promote high-quality and patient-centred decisions in surgical care, leading to better outcomes. Specific elements may cause more uncertainty or decisional conflict for patients: lack of knowledge about risks and benefits, poorly defined personal values about the importance of those risks and benefits, perception of a lack of support, unpredictable outcomes, or the impression that an inadequate decision has been made. Decisional conflict can be measured in the surgical setting using the 16-item validated patient-reported Decisional Conflict Scale (DCS). Better understanding of the reasons behind high decisional conflict can help surgeons support high-quality decisions and lead to more satisfactory outcomes and less decisional regret.