{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:19:52Z","timestamp":1790223592657,"version":"4.1.0"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research","doi-asserted-by":"publisher","award":["19K11244"],"award-info":[{"award-number":["19K11244"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020051","name":"Tamura Science and Technology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020051","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Japanese medical practice, older stroke survivors are overwhelmed with information regarding their discharge locations, creating more decision-making challenges. A randomized controlled trial evaluated the influence of decision aids (DAs) for matching older stroke patients and their families\u2019 values concerning decisional conflict and participation in discharge destination decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were randomly allocated to intervention and control groups. The intervention spanned two months, from admission to discharge, at which times participants were surveyed. DAs were provided to the intervention group, and brochures to the control group. The primary endpoint was decisional conflict, assessed using the Decisional Conflict Scale (DCS). The secondary endpoint decision-making participation was assessed using the Control Preference Scale (CPS) decision-making roles and a 10-point Visual Analog Scale for participation rate. An independent t-test analyzed decisional conflict scores and participation rates to examine between-group differences. The chi-square independence test evaluated roles in decision-making scores. Post hoc subgroup analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-nine participants (intervention group n = 51; control group n = 48) were included in the full analysis set, with a dropout rate of 38.4%. No significant group differences were found in decision-making conflict [t (99) = 0.69, p = 0.49, d = 0.14] and roles in decision-making scores [\u03c72 (5) = 3.65, p = 0.46]. However, a significant group difference was found in the participation rate [t (99) = 2.24, p = 0.03, d = 0.45]. DA tended to reduce uncertainty and promote participation rates, especially in participants living alone and unable to decide their discharge destination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of DA with older stroke patients did not significantly decrease decisional conflicts. In addition, the participation rate in decision-making increased, but their active role did not. Further studies should be conducted to understand the methods of offering DA, their ideal durations, and identify their beneficiaries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0272115","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T13:42:22Z","timestamp":1706190142000},"page":"e0272115","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["A randomized controlled trial on the effects of decision aids for choosing discharge destinations of older stroke patients"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0752-9233","authenticated-orcid":true,"given":"Yoriko","family":"Aoki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2590-2022","authenticated-orcid":true,"given":"Yuki","family":"Yonekura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"pone.0272115.ref001","author":"Ministry of Health, Labour and Welfare","year":"2021","journal-title":"White paper on aging society"},{"key":"pone.0272115.ref002","first-page":"1","article-title":"The psychological process in the recovery phase of latter-stage elderly who became hemiplegic because of a cerebrovascular disease.","volume":"7","author":"K Ojima","year":"2019","journal-title":"Bull Sci Nurs Res Ashikaga Univ"},{"key":"pone.0272115.ref003","doi-asserted-by":"crossref","first-page":"e0189266","DOI":"10.1371\/journal.pone.0189266","article-title":"Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults.","volume":"13","author":"N Roy","year":"2018","journal-title":"PLOS ONE"},{"key":"pone.0272115.ref004","first-page":"266","article-title":"Care to encourage participation of the older adult in need of long-term care in the post-discharge decision-making process: An analysis of responses shown to families and medical staff, Japanese.","volume":"32","author":"M Ono","year":"2006","journal-title":"J Clin Nurs"},{"key":"pone.0272115.ref005","first-page":"10","article-title":"The current status and challenges of a client\u2019s participation and decisions in multidisciplinary and inter-institution cooperation at the time of elderly\u2019s hospital discharge.","volume":"21","author":"R Iso","year":"2016","journal-title":"J Int Univ Health Welf"},{"key":"pone.0272115.ref006","first-page":"67","article-title":"An acute-care hospital\u2019s discharge adjustments: Difficulties in assisting the discharge of the elderly as perceived by nurses.","volume":"18","author":"K Harada","year":"2014","journal-title":"J Jpn Acad Gerontol Nurs"},{"issue":"1","key":"pone.0272115.ref007","first-page":"34","article-title":"Anxiety felt by main caretakers of cerebrovascular disease patients admitted to convalescence rehabilitation wards: Changes between about one week after admission and before discharge.","volume":"10","author":"Y Okumura","year":"2012","journal-title":"J Nurs. Shiga University Med Sci."},{"key":"pone.0272115.ref008","first-page":"41","article-title":"Factors of patients and families that affect the decision on the location of care for progressive cancer patients","volume":"8","author":"K Sakai","year":"2011","journal-title":"Ishikawa J Nurs"},{"key":"pone.0272115.ref009","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1001\/jama.2010.1208","article-title":"The shared decision-making continuum","volume":"304","author":"AA Kon","year":"2010","journal-title":"JAMA"},{"key":"pone.0272115.ref010","first-page":"CD006732","article-title":"Interventions for increasing the use of shared decision making by healthcare professionals.","volume":"7","author":"F L\u00e9gar\u00e9","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"pone.0272115.ref011","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/1471-2318-14-83","article-title":"An interprofessional approach to shared decision making: An exploratory case study with family caregivers of one IP home care team.","volume":"14","author":"F L\u00e9gar\u00e9","year":"2014","journal-title":"BMC Geriatr"},{"key":"pone.0272115.ref012","author":"A to Z inventory of decision Aids","year":"2019","journal-title":"Alphabetical List of Decision Aids by Health Topic."},{"key":"pone.0272115.ref013","author":"AM O\u2019Connor","year":"2015","journal-title":"Ottawa personal Decision Guide for people facing tough health or social decisions; 2012; updated"},{"key":"pone.0272115.ref014","first-page":"CD001431","article-title":"Decision aids for people facing health treatment or screening decisions","volume":"4","author":"D Stacey","year":"2017","journal-title":"Review. Cochrane Database Syst Rev"},{"key":"pone.0272115.ref015","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12911-016-0281-8","article-title":"Decision aids to help older people make health decisions: A systematic review and meta-analysis","volume":"16","author":"JC van Weert","year":"2016","journal-title":"BMC Med Inform Decis Mak"},{"key":"pone.0272115.ref016","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s40900-016-0040-0","article-title":"Development of a decision guide to support the elderly in decision making about location of care: An iterative, user-centered design.","volume":"2","author":"MM Garvelink","year":"2016","journal-title":"Res Involv Engagem."},{"key":"pone.0272115.ref017","first-page":"63","volume-title":"Chapter 4. Nursing and information, systematic nursing course\u2013Separate volume\u2013Nursing informatics.","author":"K Nakayama","year":"2017"},{"key":"pone.0272115.ref018","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/2047-3095.12393","article-title":"Improving older adults stroke survivors\u2019 decision-making when selecting a discharge location: A randomized controlled trial protocol","volume":"34","author":"Y Aoki","year":"2023","journal-title":"Int J Nurs Knowl"},{"key":"pone.0272115.ref019","author":"O Jacobsen MJ","year":"2013","journal-title":"Decisional needs assessment in populations; 1999; updated"},{"key":"pone.0272115.ref020","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S0140-6736(00)04337-3","article-title":"The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomised trials","volume":"357","author":"D Moher","year":"2001","journal-title":"Lancet"},{"key":"pone.0272115.ref021","first-page":"865","article-title":"Introduction and explanation of the 2017 CONSORT non-drug intervention edition. 2017 CONSORT NPT extension","volume":"47","author":"K Tsuya","year":"2019","journal-title":"Jpn Pharmacol Ther"},{"key":"pone.0272115.ref022","first-page":"881","article-title":"Factors that affect elderly stroke patients\u2019 discharge destinations in convalescence rehabilitation wards","volume":"42","author":"Y Aoki","year":"2019","journal-title":"J Int Nurs Res"},{"key":"pone.0272115.ref023","article-title":"Partial correction of notification related to the revision of medical service fee for FY 2016 and partial correction of items published in the Official.","author":"Health insurance claims review & reimbursement services","year":"2016","journal-title":"Gazette"},{"key":"pone.0272115.ref024","first-page":"6","article-title":"The functional independence measure: A new tool for rehabilitation.","volume":"1","author":"RA Keith","year":"1987","journal-title":"Adv Clin Rehabil."},{"issue":"Suppl 2","key":"pone.0272115.ref025","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1186\/1472-6947-13-S2-S2","article-title":"A systematic development process for patient decision aids","volume":"13","author":"A Coulter","year":"2013","journal-title":"BMC Med Inform Decis Mak"},{"key":"pone.0272115.ref026","doi-asserted-by":"crossref","first-page":"e4705","DOI":"10.1371\/journal.pone.0004705","article-title":"Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi).","volume":"4","author":"O Elwyn G","year":"2009","journal-title":"PLOS ONE."},{"key":"pone.0272115.ref027","doi-asserted-by":"crossref","first-page":"e30934","DOI":"10.1097\/MD.0000000000030934","article-title":"Development of a values-based decision aid to determine discharge destination: Case reports of older stroke survivors and their families","volume":"101","author":"Y Aoki","year":"2022","journal-title":"Medicine"},{"key":"pone.0272115.ref028","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1472-6947-13-50","article-title":"Development and validation of the Japanese version of the Decisional Conflict Scale to investigate the value of pharmacists\u2019 information: A before and after study","volume":"13","author":"T Kawaguchi","year":"2013","journal-title":"BMC Med Inform Decis Mak"},{"key":"pone.0272115.ref029","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/0272989X9501500105","article-title":"Validation of a decisional conflict scale.","volume":"15","author":"AM O\u2019Connor","year":"1995","journal-title":"Med Decis Making."},{"key":"pone.0272115.ref030","author":"AM O\u2019Connor","year":"2010","journal-title":"User manual\u2013Decision conflict scale; 1993; updated"},{"key":"pone.0272115.ref031","doi-asserted-by":"crossref","first-page":"2990","DOI":"10.1001\/jama.1984.03350210038026","article-title":"Do patients want to participate in medical decision making?","volume":"252","author":"WM Strull","year":"1984","journal-title":"JAMA"},{"key":"pone.0272115.ref032","first-page":"21","article-title":"The control preferences scale","volume":"29","author":"LF Degner","year":"1997","journal-title":"Can J Nurs Res"},{"key":"pone.0272115.ref033","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.2147\/PPA.S295383","article-title":"Development of Japanese versions of the control preferences scale and information needs questionnaire: Role of decision-making and information needs for Japanese breast cancer patients","volume":"15","author":"K Azuma","year":"2021","journal-title":"Patient Prefer Adherence"},{"key":"pone.0272115.ref034","author":"AM O\u2019Connor","year":"2003","journal-title":"User Manual\u2013Stage of decision making; 2000; updated"},{"key":"pone.0272115.ref035","unstructured":"Cabinet Office. Trends in older lives (2). [Cited 2022 Nov 10]. Available from: https:\/\/www8.cao.go.jp\/kourei\/whitepaper\/w-2022\/html\/zenbun\/s1_2_2.html. section 2."},{"key":"pone.0272115.ref036","unstructured":"A committee to investigate the raising of public awareness of medical care in the final stages of life. A report on the awareness survey regarding medical care at the final stage of life. [Cited 2022 Mar 8]. Available from: https:\/\/www.mhlw.go.jp\/toukei\/list\/dl\/saisyuiryo_a_h29.pdf; 2018."},{"key":"pone.0272115.ref037","first-page":"9","article-title":"Investigation of factors relating to stroke rehabilitation patients\u2019 discharge to home: Utilizing the data of rehabilitation patient databank.","volume":"18","author":"K Kojima","year":"2015","journal-title":"J Health Sci. Nihon Fukushi University."},{"key":"pone.0272115.ref038","first-page":"9","article-title":"Factors related to elderly cancer patients\u2019 switching from hospitals to home care","volume":"22","author":"I Omachi","year":"2013","journal-title":"Bull Kyushu Agric Exp Stn"},{"key":"pone.0272115.ref039","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/1467-9280.00066","article-title":"Does living in California make people happy? A focusing illusion in judgments of life satisfaction","volume":"9","author":"DA Schkade","year":"1998","journal-title":"Psychol Sci."},{"key":"pone.0272115.ref040","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/0272989X20925368","article-title":"Decision regret among informal caregivers making housing decisions for older adults with cognitive impairment: A cross-sectional analysis.","volume":"40","author":"H Elidor","year":"2020","journal-title":"Med Decis Making"},{"key":"pone.0272115.ref041","author":"AM O\u2019Connor","year":"2003","journal-title":"Workbook on developing and evaluating decision Aids"},{"key":"pone.0272115.ref042","first-page":"71","article-title":"Psychological care needs of cerebrovascular disorder patients and their families, three months after onset.","volume":"16","author":"M Kajiya","year":"2010","journal-title":"Jpn J Res Fam Nurs"},{"key":"pone.0272115.ref043","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12877-016-0395-y","article-title":"Impact of home care versus alternative locations of care on elder health outcomes: An overview of systematic reviews.","volume":"17","author":"L Boland","year":"2017","journal-title":"BMC Geriatr."},{"key":"pone.0272115.ref044","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1191\/0269215504cr807oa","article-title":"The impact of discharge to a care home on longer term stroke outcomes","volume":"18","author":"L Leeds","year":"2004","journal-title":"Clin Rehabil"},{"key":"pone.0272115.ref045","article-title":"When you need extra care, should you receive it at home or in a facility?","author":"MA Murray","year":"2010","journal-title":"Ottawa patient decision aid research group"},{"key":"pone.0272115.ref046","first-page":"68","volume-title":"Social work on discharge assistance: Formation of \u201csituational values\u201d in the patient support system","author":"H. Shimpo","year":"2014"},{"key":"pone.0272115.ref047","first-page":"166","volume-title":"Behavioral economics at the sites of medicine: Doctors and patients missing each other.","author":"F Otake","year":"2018"},{"key":"pone.0272115.ref048","first-page":"455","article-title":"Engaging patients using an interprofessional approach to shared decision making.","volume":"25","author":"S Dawn","year":"2015","journal-title":"Can Oncol Nurs J"},{"key":"pone.0272115.ref049","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12911-016-0399-8","article-title":"Involving members of vulnerable populations in the development of patient decision aids: A mixed methods sequential explanatory study","volume":"17","author":"M Dugas","year":"2017","journal-title":"BMC Med Inform Decis Mak"},{"key":"pone.0272115.ref050","unstructured":"PwC Consulting Godo kaisha. Report on the actual situation survey research on the diversification of operation forms in residences for the older people. [Cited 2022 Nov 10]. Available from: https:\/\/www.yurokyo.or.jp\/pdf."},{"key":"pone.0272115.ref051","doi-asserted-by":"crossref","first-page":"e0202975","DOI":"10.1371\/journal.pone.0202975","article-title":"\u201cPlease listen to me\u201d: A cross-sectional study of experiences of seniors and their caregivers making housing decisions.","volume":"13","author":"R Adekpedjou","year":"2018","journal-title":"PLOS ONE"},{"key":"pone.0272115.ref052","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1111\/j.1365-2702.2008.02600.x","article-title":"Discharge planning of Stroke Patients: The Relatives\u2019 Perceptions of participation","volume":"18","author":"AH Almborg","year":"2009","journal-title":"J Clin Nurs"},{"key":"pone.0272115.ref053","first-page":"119","article-title":"Japan\u2019s cultural characteristics in healthcare mentioned in overseas literature.","volume":"13","author":"N Kawai","year":"2007","journal-title":"J Chiba Acad Nurs Sci"},{"key":"pone.0272115.ref054","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.pec.2013.10.031","article-title":"Knowledge is not power for patients: A systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making.","volume":"94","author":"N Joseph-Williams","year":"2014","journal-title":"Patient Educ Couns. patient ed. patient ed"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0272115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T13:42:53Z","timestamp":1706190173000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0272115"}},"subtitle":[],"editor":[{"given":"Alessandra","family":"Solari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0272115","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2022.07.28.22277637","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}