The Ottawa personal decision guide: For people facing tough health decisions*
*Decisional Conflict Scale; 2006 O'Connor
*Ottawa Personal Decision Guide; 2006 O'Connor, Jacobsen, Stacey, University of Ottawa Health Research Institute, Canada
This guide was developed to help people who are making any health-related decision, such as whether or not to have scoliosis surgery. If you are a teen, work through the guide and talk to your parents about what you discover. If you are a parent, help your teen to work through the guide.
If you want more information about this guide or other patient decision aids, go to: http://decisionaid.ohri.ca/index.html, a website for the Ottawa Health Research Institute.
You will be guided through four steps:
- Clarify the decision.
- Identify your decision-making needs.
- Explore your needs.
- Plan the next steps.
1. Clarify the decision
| What is the decision you face? | |
|---|---|
| What is your reason for making this decision? | |
| When does this decision have to be made? | |
| How far along are you with your decision? |
□ I have not yet thought about options. □ I am considering the options. □ I am close to choosing an option. □ I have already made a choice. |
| Are you leaning toward a specific option? |
□ Yes □ No If yes, which option: |
2. Identify your decision-making needs
| A. Support | Do you have enough support and advice from others to make a choice? | □ Yes □ No |
|---|---|---|
| Are you choosing without pressure from others? | □ Yes □ No |
|
| B. Knowledge | Do you know which options are available to you? | □ Yes □ No |
| Do you know both benefits and risks of each option? | □ Yes □ No |
|
| C. Values | Are you clear about which benefits and risks matter most to you? | □ Yes □ No |
| D. Certainty | Do you feel sure about the best choice for you? | □ Yes □ No |
People who answer "No" to one or several questions are more likely to delay their decision, change their mind, feel regret about their choice, or blame others for bad outcomes. Therefore, it is important to work through steps 3 and 4 that focus on your needs.
3. Explore your needs
A. Support
| Who else is involved? | Name: | Name: | Name: |
|---|---|---|---|
| Which option does this person prefer? | |||
| Is this person pressuring you? | □ Yes □ No |
□ Yes □ No |
□ Yes □ No |
| How can this person support you? |
What role do you prefer in making your choice?
- I prefer to share the decision with ___________________________________.
- I prefer to decide myself after hearing the views of ____________________.
- I prefer that someone else decides. Who? _____________________________.
B. Knowledge
In the balance scale below, list the options and main benefits and risks that you already know. Underline the benefits and risks that you think are most likely to happen.
C. Values
Use stars (*) to show how much each benefit and risk matters to you. Five stars mean that it matters "a lot." No star means "not at all."
D. Certainty
Circle the option with the benefits that matter most to you and that are most likely to happen. Avoid the option with the risks that are most important to avoid.
| Benefits: Reasons to choose this option | How much it matters to you: Add * to ***** | Risks: Reasons to avoid this option | How much it matters to you: Add * to ***** | |
|---|---|---|---|---|
| Option #1 is: | ||||
| Option #2 is: | ||||
| Option #3 is: | ||||
4. Plan the next steps based on your need.
| Things making the decision difficult | Things you are willing to try | |
|---|---|---|
| A. Support |
You feel you do NOT have enough support. |
Discuss your options with a trusted person (such as a health professional, counsellor, family, or friends). Find out what help is on hand to support your choice (such as funds, transport, or child care). |
| You feel PRESSURE from others to make a specific choice. |
Focus on the opinions of others who matter most. Share this guide with others. Ask others to complete this guide (Finds areas of agreement. When you disagree on facts, agree to get information. When you disagree on what matters most, respect the other's opinion. Take turns to listen; mirror back what the other person has said matters most to him or her.) Find a neutral person to help you and others involved. |
|
| B. Knowledge |
You feel you do NOT have enough facts. |
Find out about the chances of benefits and risks. List your questions and note where to find the answers (such as the library, health professionals, or counsellors). |
| C. Values |
You are NOT sure which benefits and risks matter most to you. |
Review the stars in the balance scale to see what matters to you most. Find people who know what it is like to experience the benefits and risks. Talk to others who have made the decision. Read stories of what mattered most to others. Discuss with others what mattered to you most. |
| Other factors that are making the decision DIFFICULT: |
List anything else you need: | |