{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:17:43Z","timestamp":1788553063556,"version":"build-2803163510"},"reference-count":41,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In burn care, one of the most debated topics is the optimal treatment of patients with deep partial-thickness burns. With these patients, the decision must be made to perform early surgery or to wait and potentially limit, or even avoid, surgery. Both options are available in Dutch burn care, and the best treatment option is decided on clinical outcomes as well as patients\u2019 preferences. This complexity highlights the need for shared decision-making (SDM) and a decision aid (DA) to facilitate this process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to support patients and health care professionals (HPs) in the process of SDM regarding the treatment decision for deep partial-thickness burns by developing and implementing a DA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multimethod design was conducted in a Dutch burn care setting between September 2023 and October 2025 and included 3 phases. Phase 1 (needs assessment) included semistructured interviews with patients, analyzed using a qualitative descriptive approach with deductive and inductive coding, and an online survey of HPs with a descriptive analysis of closed-ended questions and inductive content analysis of open-ended questions by 2 researchers. Phase 2 (development) involved 5 co-design sessions with patients, HPs, and researchers. The think-aloud method was used for usability testing with patients and HPs. Additionally, HPs participated in acceptability testing using interviews guided by the Consolidated Framework for Implementation Research, and analyzed using deductive thematic analysis. Phase 3 (implementation) consisted of a 6-month pilot period, including patient interviews, 3 focus groups with HPs, usage data, and the Normalization Measure Development questionnaire to assess the level of normalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight patient interviews revealed 2 distinct information needs: patients seeking detailed treatment information and those preferring to defer decisions to clinicians. The HPs survey (response rate 36%) showed that burn physicians typically make the final treatment decisions, although SDM was considered preferable, and 91.2% (31\/34) supported the use of a DA. Usability testing with 4 patients and 7 HPs showed overall satisfaction, with minor revisions suggested, such as clarifying text and illustrations. Key implementation facilitators included professional engagement and local support, while infrastructure was the main barrier. The final DA comprised a paper handout sheet, an interactive website, and a summary sheet capturing patient preferences. During the pilot, the DA was distributed 42 times and used by 28 patients (67% participation rate). Both patients and HPs reported positive experiences, and the tool was considered feasible to integrate into routine care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A DA for the treatment of deep partial-thickness burns was successfully developed and implemented using a comprehensive, user-centered approach. It supports SDM and patient-centered care by providing tailored information and helping patients participate more actively in treatment decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/86789","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:11:10Z","timestamp":1788552670000},"page":"e86789-e86789","source":"Crossref","is-referenced-by-count":0,"title":["Shared Decision-Making in the Management of Deep Partial-Thickness Burns: Development and Implementation of a Multicomponent Decision Aid"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-7772","authenticated-orcid":false,"given":"Roos F C","family":"Salemans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6356-8432","authenticated-orcid":false,"given":"Robin A F","family":"Verwilligen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9443-8211","authenticated-orcid":false,"given":"Sven J G","family":"Geelen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5823-7375","authenticated-orcid":false,"given":"Margriet E","family":"van Baar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4258-3983","authenticated-orcid":false,"given":"Regina","family":"The","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5350-3600","authenticated-orcid":false,"given":"Irma","family":"Visser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1575-7884","authenticated-orcid":false,"given":"Karlijn F","family":"Joosten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0827-6645","authenticated-orcid":false,"given":"Ymke","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5311-6478","authenticated-orcid":false,"given":"Annebeth","family":"Meij-de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7207-272X","authenticated-orcid":false,"given":"Kiran","family":"Baran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4690-2213","authenticated-orcid":false,"given":"Sonja M H J","family":"Scholten-Jaegers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-4566","authenticated-orcid":false,"given":"Cornelis H","family":"van der Vlies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4120-8900","authenticated-orcid":false,"given":"Denise","family":"van Uden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"National Burn Care, Education & Research group the Netherlands","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"7","key":"R1","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1016\/j.burns.2016.03.029","article-title":"The role of silver sulphadiazine in the conservative treatment of partial thickness burn wounds: a systematic review","volume":"42","author":"Heyneman","journal-title":"Burns"},{"issue":"8","key":"R2","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1016\/j.burns.2021.01.015","article-title":"The LDI Enigma Part II: indeterminate depth burns, man or machine?","volume":"47","author":"Claes","journal-title":"Burns"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-13-2","article-title":"Cost-effectiveness of laser Doppler imaging in burn care in the Netherlands","volume":"13","author":"Hop","journal-title":"BMC Surg"},{"issue":"3","key":"R4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0299809","article-title":"Timing of surgery in acute deep partial-thickness burns: a study protocol","volume":"19","author":"Salemans","journal-title":"PLoS One"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0145-5","article-title":"Burn injury","volume":"6","author":"Jeschke","journal-title":"Nat Rev Dis Primers"},{"issue":"6","key":"R6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009715","article-title":"Early excision and grafting for burns","volume":"2022","author":"Hoogewerf","journal-title":"Cochrane Database Syst Rev"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.burnso.2024.100391","article-title":"Timing of surgery in acute burn care: a multicentre registry-based cohort study","volume":"9","author":"Salemans","journal-title":"Burns Open"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.burnso.2021.02.003","article-title":"Comparison of early surgical intervention to delayed surgical intervention for treatment of thermal burns in adults: a systematic review and meta-analysis","volume":"5","author":"Miroshnychenko","journal-title":"Burns Open"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.burns.2005.09.005","article-title":"Meta-analysis of early excision of burns","volume":"32","author":"Ong","journal-title":"Burns"},{"issue":"5","key":"R10","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1016\/j.burns.2016.05.013","article-title":"ISBI practice guidelines for burn care","volume":"42","author":"Ahuja","journal-title":"Burns"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-020-01211-0","article-title":"Shared decision making in surgery: a scoping review of patient and surgeon preferences","volume":"20","author":"Shinkunas","journal-title":"BMC Med Inf Decis Making"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01142-y","article-title":"Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review","volume":"16","author":"Waddell","journal-title":"Implement Sci"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0961-2","article-title":"Burn wound healing and treatment: review and advancements","volume":"19","author":"Rowan","journal-title":"Crit Care"},{"issue":"10","key":"R14","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1016\/j.pec.2015.06.022","article-title":"Shared decision making: concepts, evidence, and practice","volume":"98","author":"Stiggelbout","journal-title":"Patient Educ Couns"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4891","article-title":"A three-talk model for shared decision making: multistage consultation process","volume":"359","author":"Elwyn","journal-title":"BMJ"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001431.pub5","article-title":"Decision aids for people facing health treatment or screening decisions","volume":"4","author":"Stacey","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"R17","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1097\/SLA.0b013e3182864fd6","article-title":"Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis","volume":"257","author":"Knops","journal-title":"Ann Surg"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1377\/hlthaff.2011.0941","article-title":"Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions","volume":"32","author":"Veroff","journal-title":"Health Aff (Millwood)"},{"issue":"7","key":"R19","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1177\/0272989X21997330","article-title":"Guidance and\/or decision coaching with patient decision aids: scoping reviews to inform the International Patient Decision Aid Standards (IPDAS)","volume":"41","author":"Rahn","journal-title":"Med Decis Making"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1097\/TA.0000000000000998","article-title":"Creation of a decision aid for goal setting after geriatric burns: a study from the Prognostic Assessment of Life and Limitations After Trauma in the Elderly [PALLIATE] consortium","volume":"81","author":"Hodgman","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"709","DOI":"10.3390\/biomedinformatics4010039","article-title":"The development and usability assessment of an augmented reality decision support system to address burn patient management","volume":"4","author":"Veazey","journal-title":"BioMedInformatics"},{"issue":"5","key":"R22","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/00004630-200021050-00008","article-title":"Application of a model to guide ethical decision making in burn treatment","volume":"21","author":"Miller","journal-title":"J Burn Care Rehabil"},{"issue":"Supplement_1","key":"R23","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1093\/jbcr\/irae036.069","article-title":"77 utility of a decision-making aid for patient centered management of deep hand burns","volume":"45","author":"Parker","journal-title":"J Burn Care Res"},{"issue":"5","key":"R24","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful sampling for qualitative data collection and analysis in mixed method implementation research","volume":"42","author":"Palinkas","journal-title":"Adm Policy Ment Health"},{"issue":"3","key":"R25","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1046\/j.1365-2648.1997.1997025471.x","article-title":"Clarifying the concept of need: a comparison of two approaches to concept analysis","volume":"25","author":"Endacott","journal-title":"J Adv Nurs"},{"issue":"6","key":"R26","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1177\/0272989X13501721","article-title":"Toward minimum standards for certifying patient decision aids: a modified Delphi consensus process","volume":"34","author":"Joseph-Williams","journal-title":"Med Decis Making"},{"key":"R27","doi-asserted-by":"crossref","unstructured":"Ericsson KA Simon HA . Protocol Analysis: Verbal Reports as Data. The MIT Press; 1993. [doi: 10.7551\/mitpress\/5657.001.0001]","DOI":"10.7551\/mitpress\/5657.001.0001"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2019.03.018","article-title":"Methods of usability testing in the development of eHealth applications: a scoping review","volume":"126","author":"Maramba","journal-title":"Int J Med Inf"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0","article-title":"The updated consolidated framework for implementation research based on user feedback","volume":"17","author":"Damschroder","journal-title":"Implementation Sci"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-8-43","article-title":"Improving the normalization of complex interventions: measure development based on normalization process theory (NoMAD): study protocol","volume":"8","author":"Finch","journal-title":"Implement Sci"},{"issue":"2","key":"R31","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s11606-020-05912-0","article-title":"Health literacy and shared decision-making: exploring the relationship to enable meaningful patient engagement in healthcare","volume":"36","author":"Muscat","journal-title":"J Gen Intern Med"},{"issue":"7","key":"R32","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1177\/0272989X211011101","article-title":"Addressing health literacy in patient decision aids: an update from the International Patient Decision Aid Standards","volume":"41","author":"Muscat","journal-title":"Med Decis Making"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1177\/0272989X241302288","article-title":"How inclusive are patient decision aids for people with limited health literacy? An analysis of understandability criteria and the communication about options and probabilities","volume":"45","author":"Richter","journal-title":"Med Decis Making"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1093\/ehjdh\/ztac070","article-title":"What helps the successful implementation of digital decision aids supporting shared decision-making in cardiovascular diseases? A systematic review","volume":"4","author":"Peters","journal-title":"Eur Heart J Digit Health"},{"issue":"9","key":"R35","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1080\/10810730.2020.1840674","article-title":"Adapting online patient decision aids: effects of modality and narration style on patients\u2019 satisfaction, information recall and informed decision making","volume":"25","author":"De Looper","journal-title":"J Health Commun"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094670","article-title":"Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta-analysis","volume":"9","author":"Durand","journal-title":"PLoS One"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2025.109443","article-title":"Implementing decision aid use and shared-decision making in breast cancer screening: a scoping review","volume":"144","author":"Alkhaldi","journal-title":"Patient Educ Couns"},{"issue":"3","key":"R38","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1007\/s10549-020-05975-x","article-title":"Implementing a patient decision aid, a process evaluation of a large-scale pre- and post-implementation trial","volume":"185","author":"Daniela","journal-title":"Breast Cancer Res Treat"},{"issue":"4","key":"R39","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1177\/0272989X251318640","article-title":"The effect of patient decision aid attributes on patient outcomes: a network meta-analysis of a systematic review","volume":"45","author":"Stacey","journal-title":"Med Decis Making"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7624","article-title":"Decision aids that really promote shared decision making: the pace quickens","volume":"350","author":"Agoritsas","journal-title":"BMJ"},{"issue":"1","key":"R41","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-022-02853-0","article-title":"Development of an online patient decision aid for kidney failure treatment modality decisions","volume":"23","author":"Engels","journal-title":"BMC Nephrol"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:11:16Z","timestamp":1788552676000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e86789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":41,"URL":"https:\/\/doi.org\/10.2196\/86789","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"article-number":"v28i7e86789"}}