{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:13:10Z","timestamp":1779883990941,"version":"3.53.1"},"reference-count":13,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate whether the use of a patient decision aid (PDA) diminishes decision conflict in patients considering surgical treatment for stress urinary incontinence (SUI) or pelvic organ prolapse (POP) and to assess patient satisfaction concerning the PDA's user\u2010friendliness and overall utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>One hundred women attending routine urogynaecology clinic appointments were offered the PDA as part of standard care and recruited into the study. After using the PDA, participants completed a decisional conflict scale (DCS) to assess their decision\u2010making experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single\u2010site NHS tertiary\u2010level care hospital outpatient department.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population and Sample<\/jats:title><jats:p>The study included women considering surgical management for uterine\/vault prolapse or SUI. Exclusion criteria comprised individuals under 18\u2009years of age, those unable to communicate in English and patients not eligible for all surgical options presented in the PDAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients presenting to the urogynaecology clinic with symptomatic SUI or POP considering surgical treatment were invited to participate in the study. After using the PDA and at their next clinic visit, participants completed a DCS to assess their decision\u2010making experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure<\/jats:title><jats:p>The DCS assessed the level of uncertainty and difficulty participants experienced in deciding on surgical treatment after using the PDA. A DCS score of less than 25 was associated with certainty in implementing the decision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This was a prospective cohort study of 100 participants. The DCS scores for the cohorts showed low decisional conflict, with median scores of 0.8 (IQR 4.7) for the vault PDA, 6.3 (IQR 25) for the uterine PDA and 7.8 (IQR 21.1) for the SUI PDA. A sub\u2010score analysis revealed higher scores for \u2018uncertainty\u2019 and \u2018effective decision making\u2019 in 21 participants with total DCS scores above 25.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NICE PDAs are valuable tools for enhancing decision\u2010making in gynaecological surgery. However, this study highlights the need for their ongoing refinement to better address the informational and emotional aspects of patient decision\u2010making. Future research should focus on incorporating emotional support frameworks and psychological management tools to improve their clinical utility and effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18311","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:08:52Z","timestamp":1753697332000},"page":"1817-1822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Patient Decision Aids for Pelvic Floor Surgery and Impact on Decisional Conflict"],"prefix":"10.1111","volume":"132","author":[{"given":"Roberta","family":"Bugeja","sequence":"first","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield South Yorkshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0908-176X","authenticated-orcid":false,"given":"Ruth","family":"Athey","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield South Yorkshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4519-6903","authenticated-orcid":false,"given":"Swati","family":"Jha","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield South Yorkshire UK"},{"name":"University of Sheffield  Sheffield South Yorkshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1179\/cih.2008.1.3.297"},{"key":"e_1_2_12_3_1","unstructured":"NICE.Urinary Incontinence and Pelvic Organ Prolapse in Women: Management(2019). Ref Type: Online Source."},{"key":"e_1_2_12_4_1","first-page":"407","article-title":"Promise and Perils of Patient Decision Aids for Reducing Low\u2010Value Care","author":"Thompson R.","year":"2020","journal-title":"BMJ Quality and Safety"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03982-1"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-04047-z"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X9501500105"},{"issue":"2","key":"e_1_2_12_8_1","article-title":"A Systematic Development Process for Patient Decision Aids","volume":"13","author":"Coulter A.","year":"2013","journal-title":"BMC Medical Informatics and Decision Making"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38926.629329.AE"},{"issue":"4","key":"e_1_2_12_10_1","first-page":"163","article-title":"The Ottawa Patient Decision Aids","volume":"2","author":"O'Connor A. M.","year":"1999","journal-title":"Effective Clinical Practice"},{"key":"e_1_2_12_11_1","volume-title":"First Do No Harm","author":"IMMDS","year":"2020"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.22743"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X19896348"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.18103"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.18311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T07:45:17Z","timestamp":1759823117000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.18311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":13,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/1471-0528.18311"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.18311","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]},"assertion":[{"value":"2025-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}