Background: Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to\r\nmake decisions about treatment options. However, they are rarely utilised to help those with chronic or age\r\nrelated conditions to make decisions about care services. Decision aids should also be useful for carers of people\r\nwith decreased decisional capacity. These carers� choices must balance health outcomes for themselves and for\r\nsalient others with relational and value-based concerns, while relying on information from health professionals. This\r\npaper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make\r\nevaluative judgements of community services, particularly respite care.\r\nMethods: A mixed method sequential study, involving qualitative development and a pilot randomised controlled\r\ntrial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to\r\ninform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of\r\npeople with dementia to either receive the service decision aid at the start or end of the study. The primary\r\noutcome was measured by comparing the difference in carer burden between the two groups three months after\r\nthe intervention group received the decision aid. Pilot data was collected from carers using intervieweradministered\r\nquestionnaires at the commencement of the project, two weeks and 12 weeks later.\r\nResults: The qualitative data strongly suggest that the intervention provides carers with needed decision support.\r\nMost carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change\r\nbetween baseline and three month follow-up, the intervention group had less increase in burden, a decrease in\r\ndecisional conflict and increased knowledge compared to control group participants.\r\nConclusions: While these results must be interpreted with caution due to the small sample size, all intervention\r\nresults trend in a direction that is beneficial for carers and their decisional ability. Mixed method data suggest the\r\ndecision aid provides decisional support that carers do not otherwise receive. Decision aids may prove useful in a\r\ncommunity health services context.
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