Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 20, 2022
Date Accepted: Jan 20, 2023
Date Submitted to PubMed: Jan 23, 2023
Decisions and decisional needs of Canadians from all provinces and territories during the COVID-19 pandemic: population-based cross-sectional surveys
ABSTRACT
Background:
During the COVID-19 pandemic, Canadians faced difficult health-related decisions. It is important to identify their decision making needs to provide person-centred care, to improve health outcomes, and to inform future pandemic preparedness.
Objective:
We sought to identify their decisions and decisional needs.
Methods:
Our study was co-designed by researchers and knowledge users. Informed by CHERRIES reporting guideline, we conducted two online surveys of random samples drawn from Leger consumer panel of 400,000 Canadians (06/2020-05/2021). Participants were adults making decisions for themselves or making decisions for someone else (e.g., parents for children, caregivers for seniors). We assessed decisions and decisional needs including decisional conflict and decision regret using valid, reliable instruments. Analysis was informed by the Ottawa Decision Support Framework.
Results:
There were 1454 and 438 parents/caregivers who identified a difficult decision. Common decisions were (adults; parents/caregivers): COVID-19 vaccination (34%;20%), managing a health condition (17%;11%), other COVID-19 decisions (11%;19%), mental healthcare (9%;6%) and medication treatments (8%;5%). Caregivers reported decisions about moving family members to/from nursing or retirement homes (11%). Adults (22.2%) and parents/caregivers (21.7%) had significant decisional conflict. Factors making decisions difficult were worrying about choosing the wrong option (38%;42%), worrying about getting COVID-19 (35%;40%), public health restrictions (29%;36%), information overload (21%;18%), difficulty separating misinformation from scientific evidence (20%;18%), and difficulty discussing decisions with clinicians (15%;12%). For 1318 adults and 366 parents/caregivers who had made a decision, 26.8% and 34.2% had decision regret. Over 50% of respondents made their decision alone without considering opinions of clinicians.
Conclusions:
During the COVID-19 pandemic, Canadians reported unmet decision-making needs and many felt decision regret.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.