Development and pre/post testing of a decision aid supporting Chinese parental and young women's HPV vaccination decision-making.

We developed and tested the acceptability and utility of a novel HPV vaccination decision aid (DA) among Chinese young women aged 18-26 years and parents of adolescent girls aged 9-17 years. From March to May 2016, a total of 101 parents plus 109 young women completed baseline surveys assessing their HPV vaccination knowledge, decision self-efficacy, decision conflict, and HPV vaccination intention. Two weeks after receiving the DA, 84 (83.2%) parents and 92 (84.4%) young women completed re-assessments. Chi-square tests or t-tests were performed to compare the before-and-after differences. Cohen's d was calculated to indicate the effect size. After reading the DA, both participating young women's and parents' knowledge of HPV vaccination (Cohen's d = 0.62 among young women and d = 0.59 among parents) and decision self-efficacy (d = 0.38 among young women and d = 0.59 among parents) significantly increased. Both young women's and parents' decision conflict (d = -0 · 98 and -1.06) significantly decreased. The proportion of young women intending to receive HPV vaccination and parents deciding to vaccinate daughters against HPV significantly increased (p < 0 · 0001). The DA showed good acceptability and utility facilitating HPV vaccination decision-making for most Chinese young women and parents of adolescent girls. Further randomized controlled trials of this tool are essential.

Conflict when making decisions about dialysis modality.

AIMS AND OBJECTIVES: To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. BACKGROUND: Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. DESIGN: A predictive correlational cross-sectional study design was used. METHODS: Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. RESULTS: The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. CONCLUSIONS: Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. RELEVANCE TO CLINICAL PRACTICE: When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis predialysis education, increase dialysis knowledge and provide professional support.

Exploring Cultural and Religious Effects on HPV Vaccination Decision Making Using a Web-Based Decision Aid: A Quasi-experimental Study.

BACKGROUND: Human papillomavirus (HPV) poses a significant public health concern, as it is linked to various serious health conditions such as cancer and genital warts. Despite the vaccine's safety, efficacy, and availability through national school programs, HPV vaccination rates remain low in Israel, particularly within the ultra-Orthodox community due to religious and cultural barriers. Decision aids have shown promise in facilitating shared decision making and promoting informed choices in health care. This study aimed to assess the impact of a novel Web-based decision aid on HPV vaccination intentions, knowledge, decision self-efficacy, and decisional conflict among Israeli parents and young adults, with a specific focus on exploring differences between religious groups. METHODS: Two Web-based decision aids were developed for parents of children aged 10 to 17 y (n = 120) and young adults aged 18 to 26 y (n = 160). A quasi-experimental study was conducted among Hebrew-speaking parents and young adults eligible for HPV vaccination. Participants completed pre- and postintervention questionnaires assessing vaccination intentions, knowledge about HPV, decision self-efficacy, and decisional conflict. RESULTS: The decision aid significantly improved intentions toward HPV vaccination among most religious groups, except the Jewish ultra-Orthodox community. Ultra-Orthodox participants exhibited reluctance to vaccinate themselves or their children (odds ratio [OR] = 0.23, P < 0.001 for parents' group; OR = 0.43, P < 0.001 for young adults' group). Parental preference for vaccinating girls over boys (OR = 2.66, P < 0.001) and increased inclination for vaccination among Muslim-Arabs were observed (OR = 3.12, P < 0.001). Knowledge levels improved among ultra-Orthodox participants but not decisional conflict and self-efficacy. CONCLUSIONS: The Web-based decision aid positively influenced the quality of HPV vaccination decision making among various religious groups in Israel, except for the ultra-Orthodox community. Culturally tailored approaches that address specific community concerns are essential for informed decision making. HIGHLIGHTS: Human papillomavirus (HPV) vaccination rates in Israel are substantially lower than those of other routine vaccinations, particularly among religious and ultra-Orthodox communities, largely due to sociocultural beliefs and misinformation.A newly developed Web-based decision aid was implemented in a study involving parents and young adults to evaluate its impact on vaccination intent, knowledge about HPV, decision self-efficacy, and decisional conflict.While the decision aid significantly enhanced vaccination intention, knowledge, and perceived behavioral control among various religious groups, it did not yield the same outcomes within the ultra-Orthodox Jewish community.This study highlights the vital role of cultural adaptation in HPV vaccine decision aids within Israel, revealing significant disparities in vaccination perceptions and decisions among diverse religious and cultural groups.

The role of career decision self-efficacy as a mediator of peer support on students' career adaptability.

This study aims to determine the role of career decision self-efficacy (CDSE) as a mediator of the relationship between peer support and career adaptability among college students. Furthermore, students are in a realistic period of career development, but in reality, the level of adaptability is still low because the knowledge and career guidance in Indonesia only start at the college level, or at least high school. This condition makes recent graduates experience confusion in determining careers, thereby affecting their ability to adapt. One of the most influential external factors of career adaptability is peer support, where students spend more time with friends and provide information, career suggestions, emotional support, and being role models to each other. CDSE was selected as a moderator because career adaptability can be enhanced through self-efficacy sources. The participants used were final-year college students in Indonesia (N = 538). Data was then collected using convenience sampling techniques. The instruments used in this study include Career Adapt-Abilities Scale, Career-Related Peer Support, and Career Decision Self-Efficacy-Short Form. The results showed that CDSE fully mediated peer support on adaptability (c = 0.247; p < .001). Furthermore, peer support as an external factor is inadequate to enhance career adaptability. This indicates that internal factors are needed to help students adapt to changes in the working world and career choices. Students who only obtain social support from campus friends regarding career cannot adapt when they lack the confidence to make decisions with the information and knowledge provided.

Development and Appraisal of a Web-Based Decision Aid for HPV Vaccination for Young Adults and Parents of Children in Israel-A Quasi-Experimental Study.

BACKGROUND: This study aimed to develop and evaluate the effectiveness of two web-based decision aids designed to help parents of children aged 10-17 years and young adults aged 18-26 years make informed decisions about the HPV vaccine. METHODS: The decision aids were developed according to the International Patient Decision Aid Standards (IPDAS) criteria and included information about the vaccine, probabilities of benefits and side effects, personal narratives, and values clarification. The study utilized a quasi-experimental design and included 120 Hebrew-speaking parents and 160 young adults. Participants completed baseline surveys and, two weeks after using the decision aid, completed a follow-up survey. RESULTS: Both parents and young adults experienced a reduction in decisional conflict, an increase in self-efficacy, and greater confidence in the safety and effectiveness of the vaccine. The proportion of participating parents deciding to vaccinate their children against HPV increased from 46% to 75%, and the proportion of participating young adults leaning towards receiving the HPV vaccine increased from 64% to 92%. CONCLUSIONS: The study highlights the importance of using decision aids to support informed decision making about vaccination and suggests that web-based decision aids may be a useful tool for supporting Israeli parents and young adults to make HPV vaccination decisions.

How cyberchondria and decision self-efficacy shapes the acceptability of COVID-19 vaccine: A gender-based comparison.

Objective: Alarmingly, the individuals' reach and coverage to get vaccinated in developing regions during the pandemic is a massive challenge for concerned authorities. This study aimed to demonstrate how cyberchondria play a significant role in a classical health belief model. Cyberchondria may influence cognitive factors (e.g. self-efficacy), which may contribute to an increase in attitude-behavior gap. Especially in the context of a health-centric scenario, it may discourage individuals to take protective measures. Method: By using the cross-sectional research design, the authors conducted a quantitative survey in Pakistan and collected 563 responses from 303 male respondents (rural = 91; urban = 212) with (Urban M:35.5, standard deviation (SD):13.4) and rural M:37.5, SD:8.4). Result: The findings indicate that decision self-efficacy among males is stronger than that in females. It dominates other determinants, which can dampen the individuals' intentions to get vaccinated. For instance, the effect of conspiracies and perceived seriousness was noted nonsignificant and weak. In females, perceived seriousness was stronger determinant than in males. In addition, the negative effect of decision self-efficacy was noted in the case of females, and conspiracy and cyberchondria had a negative role. Conclusion: This study highlights valuable implications for future research in infodemic, health communication and health literacy, and practical implications for regulatory bodies and public administration.

Research on the impact of basic psychological needs satisfaction on career adaptability of Chinese college students.

Introduction: With social changes, the realization of smooth and satisfactory employment of college students is an issue that requires deep thought. Basic psychological needs satisfaction play an important role as a guiding factor that affects students' career adaptability. This study aims to explore the relationship and mechanism between the satisfaction of students' basic psychological needs satisfaction and their career adaptability. Methods: A survey is conducted among students from six different universities across the country, using the Basic Psychological Needs Satisfaction Scale, the Career Adaptability Scale, the Career Decision Self-Efficacy Scale, and the Career Outcome Expectations Scale. Results: The satisfaction of basic psychological needs, career decision self-efficacy, and career outcome expectations are all significantly positively correlated with career adaptability.Career decision self-efficacy plays a partial mediating role between basic psychological needs satisfaction and career adaptability among college students. The moderated mediation model found that career outcome expectations play a regulatory role in the effect of career decision self-efficacy on career adaptability. Discussion: College students' basic psychological need satisfaction can positively predict career adaptability directly and indirectly affect career adaptability through career decision self-efficacy, and career outcome expectations have a moderating role between career decision self-efficacy and career adaptability.

The Influence of Overparenting on College Students' Career Indecision: A Moderated Mediation Analysis.

Purpose: Avoiding difficulties in career decision-making has long been recognized as an important lifelong pursuit for individuals. Parental influence is an important environmental factor in college students' career decision-making. In recent years it has been shown that overparenting can be a risk factor that hinders college students' career development. Participants and Method: This study was conducted with third-year students from four universities in Northeast China, and 743 valid questionnaires were received. With SPSS 24.0 and PROCESS plug-in, we built a moderated mediation model to examine the mediation effects of career expectation pressure and career decision self-efficacy between overparenting and career indecision and parent-adolescent expectation congruence's moderating role in this relationship. Results: The results of this study indicate that overparenting is positively associated with college students' career indecision. Career expectation pressure and career decision self-efficacy mediate the relationship between overparenting and career indecision. In addition, parent-adolescent expectation congruence moderated the adverse relationship of overparenting on career expectation pressure and career indecision. Conclusion: This study builds on previous research to explore the potential mechanisms of overparenting on adolescent career indecision. The results of this study may have implications for interventions in adolescent career decision-making to reduce the negative impact of overparenting on adolescent career development by providing feasible and effective interventions for overparenting families. Limitation: Other factors (eg, proactive personality) may also have played a positive role in this relationship in this study. We hope future studies will explore the moderating effects of different personality traits.

Parental Decision Making Regarding COVID-19 Vaccines for Children under Age 5: Does Decision Self-Efficacy Play a Role?

BACKGROUND: COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents' intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about vaccination (decision self-efficacy) was associated with these intentions. METHOD: We conducted a cross-sectional online survey of U.S. parents between 23 March and 5 April 2022. We examined associations between parental intention to vaccinate their young children (

Development and Pilot Usefulness Testing of an Interactive Computerized Patient Decision Aid for Intraocular Lens Selection Before Cataract Surgery.

PURPOSE: Modern cataract surgeries aim to treat impaired vision and also improve quality of life. An appropriate pre-operative selection of the intraocular lens is important to post-operative quality of life. Patients often have difficulty in choosing the best fit for individual needs. Patient decision aids (PDAs) are useful tools to assist patients in such decision-making process. However, most PDAs are paper-based and lack user interaction. This study is aimed to develop and evaluate an interactive computerized patient decision aid (cPDA) to help patients in the selection of an appropriate intraocular lens model before cataract surgery. MATERIALS AND METHODS: Patients and their families who were making the decision regarding intraocular lens selection before cataract surgeries were eligible to participate in this study. A cPDA was built on an interactive robot, to help the patients in the decision-making process. The usefulness of the cPDA was measured with the Decision Self-Efficacy (DSE) scale and Preparation for Decision Making (PrepDM) scale. RESULTS: A total of 50 participants (18 men and 32 women) were enrolled in the pilot test. The mean pre-cPDA DSE score was 46.5 ± 13.6, and the post-cPDA DSE score was 72.6 ±12.8. The average gain score on DSE was 26.1, and the standard deviation was 8.0. The gain score on DSE was statistically significant, and the effect size was bigger than 3. The patients with junior or senior high degrees had the highest gain score on DSE, and the ones with college or above degrees had the lowest. The patients with college or above degrees had the highest PrepDM score, and the ones with elementary school or below had the lowest. Age and sex were not significant correlates of PrepDM. The patients with college or above degrees had the highest preparedness, but the lowest gain on DSE. CONCLUSION: Education levels are associated with the usefulness of cPDA, both for the preparedness and decision efficacy of patients. The results provide insight into the feasibility of cPDA for the decision-making of pre-operative intraocular lens selection.

Effectiveness of question prompt lists in patients with breast cancer: A randomized controlled trial.

OBJECTIVES: To evaluate the effectiveness of a question prompt list (QPL) in decision self-efficacy, decision-making participation, patient-physician communication, decisional conflict or regret, and health status in patients with breast cancer. METHODS: A total of 240 patients with breast cancer were randomly assigned to a QPL group or control group (n = 120 each). The intervention and control groups received an additional educational QPL booklet and routine care, respectively. RESULTS: The intervention group exhibited significant improvements in decision self-efficacy, perceived patient-physician interactions, and patient-physician communication compared with the control group. Multilevel modeling analyses revealed significant group-time interaction effects on decision self-efficacy (ß = 9.99, P < 0.01), perceived patient-physician interactions (ß = 8.10, P < 0.01), patient-physician communication (ß = 5.02, P < 0.01), and anxiety status (ß = -3.78, P < 0.05). The QPL intervention exerted more favorable effects than routine care, with repeated measurements of the same patients and the data of patients under the care of the same surgeons accounted for. CONCLUSIONS: The QPL intervention exerted multidimensional effects on decision-making outcomes among patients with breast cancer. PRACTICAL IMPLICATIONS: Clinicians can integrate a QPL into routine care for patients with breast cancer.

Perceived parenting styles, thinking styles, and gender on the career decision self-efficacy of adolescents: how & why?

Career decision self-efficacy (CDSE), i.e., the ability to successfully make important career-related decisions, is influenced by perceived parenting styles, thinking styles, and gender. Thus, this non-experimental study examined the effects of these factors on the CDSE of 617 high school students in Jakarta, Indonesia. According to the measuring instruments (CDSE Scale-Short Form, Parental Authority Questionnaire, and Thinking and Styles Inventory-Revised II), the adolescents' CDSE was influenced by the authoritative and permissive parenting styles, and three types of thinking styles. Moreover, the thinking styles mediated the relationship between the perceived parenting styles and CDSE, while gender acted as a homologizer.

Career Exploration and Career Decision Self-Efficacy in Northwest Chinese Pre-service Kindergarten Teachers: The Mediating Role of Work Volition and Career Adaptability.

Studies have documented that career exploration is significantly associated with CDSE, but how this association occurred is not clear yet. This study committed to clarifying the mechanism underlying the relationship between career exploration and CDSE by investigating the mediation effect of work volition and career adaptability among 586 pre-service kindergarten teachers. The participants are recruited from Ningxia Hui Autonomous Region in northwest China, covering Han, Hui, and other minorities. They took part in a two-wave (6 months apart) longitudinal survey and reported on their career exploration at T1, work volition, career adaptability, and career decision self-efficacy (CDSE) at T2. Results showed that T1 career exploration is directly related to the T2 CDSE. Further, career exploration contributed to the CDSE through both the separated mediation path and the chained mediation path of T2 work volition and T2 career adaptability. The results suggest that individuals who engage in more career exploration activities are likely to have more confidence in their abilities to make career decisions over time, which was partially and serially explained by individuals' perception of capacity despite constraints and greater self-regulatory strength. This study is a first attempt to deeply clarify the link between career exploration and CDSE, and the findings shed light on the independent and serial mediating effects of work volition and career adaptability. The implications and limitations are discussed.

Efficacy of a decision support intervention for reducing decisional conflict in patients with elevated serum prostate-specific antigen: A randomized controlled trial.

PURPOSE: The study purpose is to test the efficacy of a decision support intervention for reducing decisional conflict, increasing prostate biopsy knowledge, and enhancing decision self-efficacy in patients with elevated serum prostate-specific antigen. METHOD: The study is based on a randomized pre-post test design. A convenience sample of men with elevated prostate-specific antigen was recruited and 1:1 randomized to the intervention and control groups. The intervention group received the decision support intervention and the control group received health education. Data were collected at the baseline and post-test by using self-reported questionnaires, including the Prostate Biopsy Knowledge Scale, the Decision Self-Efficacy Scale, the Decisional Conflict Scale, and questions regarding the prostate biopsy decision (post-test only). Data on prostate-specific antigen levels were collected from the patients' medical records. RESULTS: A total of 110 patients participated in the study. At baseline, the intervention group had significantly higher knowledge scores than the control group. The analysis of the covariance model with the baseline score as a covariate was used to analyze the intervention effect. After controlling for the baseline scores, the mean differences (95% CI) between the two groups were 11.75 (11.17-12.32), 76.45 (72.52-80.37), and -23.53 (-26.31-20.20) for knowledge, decision self-efficacy, and decisional conflict, respectively. The between-group difference in willingness to accept prostate biopsy at the post-test was not statistically significant (χ2= 1.704). CONCLUSIONS: The decision support intervention significantly reduced patients' decisional conflict while improving their knowledge and self-efficacy. However, the intervention did not affect patients' biopsy decision.

Simplifying the Measurement of College Students' Career Planning: the Development of Career Student Planning Scale during the COVID-19 Pandemic.

We created a new, 8-item scale called "Career Student Planning Scale (CSPS)" for a valid and reliable measure regarding college students' career planning during a traumatic event, such as a pandemic. CSPS is conceptually similar to the career decision-making difficulty questionnaire (CDDQ) and the career decision self-efficacy (CDSE) scale. CSPS leans towards questions about college students' perceptions about career planning, rather than intuitions about career decision-making; it also inquires about how participants conceptualize about their career plans to be correct, rather than the more extreme idea about how their intuitions are correct: we developed this scale to capture the latter construct. We included the coronavirus anxiety scale (CAS), CDDQ, the general procrastination scale (GPS), and the CDSE short form (CDSE-SF) as covariates to ensure that CSPS has distinct effects on their career paths. Our findings indicate the CSPS has acceptable psychometric properties and demonstrates a valuable input to those measures.

Investigating Psychometrics of Career Decision Ambiguity Tolerance Scale.

This study aimed to validate career decision ambiguity tolerance scale-Korean form applicable to a Korean sample. In study 1, 17-items from the original 18-item career decision ambiguity tolerance scale were valid based on IRT. In study 2, using the confirmatory factor analysis, we showed that excluding item 4 from the original scale is better than including it in the three factors model. Given the results of study 1 and 2, the constructs in the 17-item career decision ambiguity tolerance scale-Korean form were valid. In study 3, career decision ambiguity tolerance positively predicted career decision-making self-efficacy, career indecision, and career adaptability, respectively, after controlling for calling and career search self-efficacy. Thus, the incremental validity of the career decision ambiguity tolerance scale-Korean form was ensured. In study 4, the reliability of the scale was retained as the test-retest (conducted over a 4-week period) demonstrated adequate results.

Exploring Health Information-Seeking Preferences of Older Adults With Hypertension: Quasi-Experimental Design.

BACKGROUND: Patients' engagement in health care decision making is constituted by at least two behaviors: health information seeking and active involvement in medical decisions. Previous research reported that older adults desire a lot of information, but want to participate in decision making to a lesser degree. However, there is only limited evidence on the effect of desire for health information on seniors' perceived confidence in making an informed choice (ie, decision self-efficacy). OBJECTIVE: The goal of this study was to investigate the role desire for health information has for older patients. More specifically, it tested whether decision self-efficacy increases as a function of an assisted computer-based information search. Additionally, the study allowed insights into the sources seniors with hypertension prefer to consult. METHODS: A sample of 101 senior citizens (aged ≥60 years) with high blood pressure in the Italian-speaking part of Switzerland answered a questionnaire before and after an informational intervention was applied. The intervention consisted of offering additional information on hypertension from five different sources and of providing the information the participant desired. Preference for receiving this information was the major independent variable. The main outcome measure was decision self-efficacy (assessed at baseline and posttest). Analyses of covariance were conducted to detect differences between and within who desired additional hypertension-related content (intervention group) and "information avoiders" (control group). RESULTS: Health care professionals firmly remain the preferred and most trusted source of health information for senior patients. The second most consulted source was the internet (intervention group only). However, among the total sample, the internet obtained the lowest credibility score. A significant increase in decision self-efficacy occurred in seniors consulting additional information compared to information avoiders (F1,93=28.25, P<.001). CONCLUSIONS: Consulting health information on a computer screen, and assistance by a computer-savvy person, may be a helpful activity to increase perceived confidence in making treatment decisions in seniors with hypertension.

The relationship between personal knowledge and decision self-efficacy in choosing trial of labor after cesarean.

INTRODUCTION: The number of women in the United States giving birth via cesarean remains high as the number of vaginal births after cesarean (VBAC) declines. The purpose of this study was to explore how personal knowledge and decision self-efficacy of women who had a prior cesarean birth affected their decision about mode of birth in a subsequent pregnancy. METHODS: A sample of 45 pregnant women with a history of a prior cesarean birth between 10 and 22 weeks' gestation were surveyed to assess their knowledge of the risks and benefits of trial of labor after cesarean (TOLAC) and elective repeat cesarean delivery (ERCD), and their degree of decision self-efficacy related to their choice of mode of birth for the present pregnancy. RESULTS: Decision self-efficacy was not a significant predictor of choice for mode of birth (P = 0.58). Knowledge scores of women who chose ERCD ranged from 0 to 10 (mean [SD], 4.64 [2.94]). Of women who chose TOLAC, knowledge scores ranged from 0 to 13 (mean [SD], 5.90 [3.64]) out of a total possible score of 14. Knowledge was found to be a significant factor in the decision-making process for mode of birth (P = 0.03). Among women who were deemed to have high knowledge, 55% chose TOLAC, whereas 24% of women with high knowledge chose ERCD. The likelihood of a woman with high knowledge scores choosing a TOLAC was 3.9 (95% confidence interval [CI], 1.09-13.81) times the odds of a woman with low knowledge scores choosing ERCD. DISCUSSION: In this study, more knowledge about the risks and benefits of TOLAC and ERCD was found to be positively associated with the decision for TOLAC. This finding is important for health care providers when counseling women who have had a prior cesarean about their choices regarding mode of birth during a subsequent pregnancy. Supplying women with complete and accurate information about the risks and benefits of both choices may help increase the number of women who opt for TOLAC.