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Applying a Patient Decision Aid to Facilitate Decision Making in Women with Pelvic Organ Prolapse



Parallel abstracts

The uterus, ovary, bladder, rectum, and other organs in the pelvic cavity are supported by and fixed to the pelvic floor muscles and ligament fascia. When the pelvic floor muscles loosen or the ligament fascia breaks, the organs in the pelvic cavity can no longer be supported, which may cause prolapse or protrusion of the uterus, namely pelvic organ prolapse. It is a common benign disease in women, which often contributes to anxiety, depression, and nervousness-thus affecting the women's quality of life. This article discusses the development of decision aids through the sharing of relevant information with women with pelvic organ prolapse. By inviting these women to discuss the problems they face, the details they need, and the methods they choose, patient-centered care can be provided with greater facility. In this study, a decision aid for the treatment decisions of women with pelvic organ prolapse was constructed. The results demonstrated that the women's degree of anxiety decreased from 57.6% to 28.6%. After fully explaining and communicating relevant information, the surgery rate decreased from 57.1% to 28.6% and that of pessary use increased from 14.3% to 42.8%. This shared decision-making process may enhance women's health literacy and promote doctor-patient relationship and communication. The development process provided in this article may provide an example for other health care staff to develop additional medical decision-making aids, which can consequently improve care quality and increase patient benefit.


Bugge, C., Adams, E. J., Gopinath, D., & Reid, F. (2013). Pessaries (mechanical devices) for pelvic organ prolapse in women. Cochrane Database of Systematic Reviews, (2).
Bø, K. (2012). Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World Journal of Urology, 30(4), 437-443.
Coulter, A., Stilwell, D., Kryworuchko, J., Mullen, P. D., Ng, C. J., & van der Weijden, T. (2013). A systematic development process for patient decision aids. BMC Medical Informatics and Decision Making, 13 Suppl 2, S2.
Culligan, P. J., Scherer, J., Dyer, K., Priestley, J. L., Guingon-White, G., Delvecchio, D., & Vangeli, M. (2010). A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength. International Urogynecology Journal, 21(4), 401-408.

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