The Investigator aims to elicit the patient and provider experiences through conducting a
90-minute interview, using an interview guide the research team has developed, using
established qualitative research methods for in-depth individual interviews. The team
will structure the interviews with broad, open-ended questions to elicit personal
thoughts, emotions and experiences regarding decision making for urinary diversion. The
team will use the information collected from this interview to make a tool valuable in
developing a patient decision aid. For patients who have not undergone surgery yet, the
team will ask the patient if it is okay to contact after their surgery to reassess the
patients responses to the same questions from the first interview.
In Aim 2, the team will complete part one of the Ottawa decision framework by assessing
the patients' and urologists' determinates of decisions for urinary diversion and
identify support needs. Using established qualitative research methods for in-depth
individual interviews, the team will structure the interviews with broad, open-ended
questions to elicit personal thoughts, emotions and experiences regarding decision making
for urinary diversion.
Informed by Aim 2 the team will develop a web-based development of a decision aid. The
development process will use both the Ottawa decision support and IPDAS to center the
design empathetic to the user. The aim will be consistent with principles where the users
take priority in the IPDAS guidelines framework and the needs assessment framework. The
team will develop a decision support tailored to patients needs who are undergoing
urinary diversion and then evaluate the decision making process. The decision aid will
use the preferences from the themes of the individual interviews to give patients a
preferred method of urinary diversion. The team will perform this in a pre-post fashion.
As mentioned previously, patients will be recruited from the urologists' clinical work.
The Indiana and Neobladder patients may have different vantage points in the
perioperative period, however at 6-months this should no longer be different. In
addition, the team will have patients use the decision aid at 1-month postoperatively to
obtain feedback. Getting patient feedback from the group will be critical with such a
large number of patients recruited. The research assistant will identify eligible
patients prior to their clinic encounter and obtain informed consent. Patients will then
complete the decision aid prior to the visit with the surgeon and bring the completed
tool into the clinical encounter. After completing the visit, the patient and research
assistant will complete the questionnaires assessing acceptability, knowledge, treatment
decision and decisional conflict. One month after surgery, our team will also complete
the same questionnaires, as well as patient satisfaction and regret at the 6-month
follow-up visit. If patients are not available for the visit, our team will attempt to
complete telehealth or telephone interviews.