15250-m-cuypers

157 Care providers evaluation of DA and usual information 8 of 34 questions, grouped into four categories of factors determining implementation success; 1) instrument related factors (e.g. ‘The DA provides all information necessary to work with it appropriately’), 2) advantages and disadvantages of DA use in daily routine (e.g. ‘The DA makes it easier to discuss treatment options with patients’), 3) outcomes of DA use (e.g. ‘DA use reduces uncertainty about treatment choice in patients’), and 4) procedural factors (e.g. ‘I offer the DA to every eligible patient’). All statements were answered on a five point likert-scale (‘totally disagree – totally agree’ or ‘never – often’). The questionnaire ended with an overall evaluation of DA satisfaction (‘Overall, how satisfied are you with the DA’, with 1-very dissatisfied to 10-very satisfied). All questions were in Dutch, derived from the original Dutch MIDI questionnaire and further specified to DA use 22 . The MIDI has proven to be a useful evaluation instrument in a range of Dutch studies on implementation of health innovations 23, 24 . Additional introductory questions were asked about the familiarity with the DA (‘To what degree are you familiar with the DA content’, with the answer scale ranging from 1-‘I do not know the DA content’ to 4-‘I have read the DA thoroughly’), the number of patients to whom a DAs had been offered by the individual respondent (with answer categories ‘none’, ‘between 1 and 5’, ‘between 6 and 10’ ‘more than 10’) and reasons for not offering a DA to an eligible patient, with ten response categories of often reported barriers from literature (e.g., time constraints) and an open answer option. As participants in the control arm group had no DA experience, they were only asked for their expectations on theMIDI-categories outcomes and procedural factors for when aDA would be implemented. Additionally, questions were asked about the content of usual information routines (‘what is provided to patients as usual information’, with seven of the most common materials as answering scale; e.g. oral information, hospital leaflets or brochures and an open field to report additional materials), health care providers’ satisfaction (‘how satisfied are you with the content of information patients receive in your hospital’, with answers ranging from 1-not at all satisfied to 10-very satisfied) and perceived patient satisfaction with usual information (‘how satisfied do you expect that patients are with the current information’, with answers ranging from 1-not at all satisfied to 10- very satisfied). We also asked health care providers to estimate the information burden experienced by patients (‘how do you perceive the current amount of information that is provided to patients’with answers ranging from 1-patients receive too little information to 10-patients receive too much information) and the estimated decision-making difficulty (‘in general, how difficult do you expect patients experience treatment decision-making’, with answers ranging from 1-no difficulty to 10-much difficulty). All participants were asked for basic demographics (gender, age, occupation and affiliation). Due to the limited number of participants per individual institution, filling in age was not obligatory to ensure anonymity.