Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Example of Assessment/Evaluation Tool (The Ottawa Personal Decision Guide)
The Ottawa Personal Decision Guide is used to assist patients who are facing tough decisions. It will help them identify their personal needs, plan the next steps, track their progress, and communicate their views to others involved in the decision. The skills they learn here will also help them make other decisions in the future.
 
The 5 guiding steps:
1. Clarify the decision.
2. Identify your role in decision making.
3. Assess your decision making needs.
4. Weigh the options.
5. Plan the next steps.
 
The guide can be used more than once to track patient’s progress in decision making.
 
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? Date ____________________________________________________________________________________________________________________________________________________________
 
How far along are you with your decision?
a. I have not yet thought about options
b. I am considering the options
c. I am close to choosing an option
d. I have already made a choice
 
2. Identify your role in decision-making.
 a. I prefer to decide on my own or after considering the options of others.
b. I prefer to share the decision with:
c. I prefer that someone else decides for me, namely
 
3. Assess your decision-making needs.
 People make better decisions if they feel confident in four areas.
1. Knowing the options
2. Feeling clear about what is important to them
3. Having enough help from others in deciding
4. Feeling sure that they are making the best choice
 
AREAS
 
First Time:
Date:
Changes:
Date:
What I know
Do you know which options you have?
Do you know the good and bad points of each option?
Yes                 No
 
 
Yes                 No
Yes              No
 
 
Yes              No
What's important to me
Are you clear about which good and bad points are most important to you?
Yes                 No
 
 
Yes                 No
Yes              No
 
 
Yes              No
How others help
Do you have enough support from others to make a choice?
Are you choosing without pressure from others?
Yes                 No
 
 
Yes                No
Yes              No
 
 
Yes              No
How sure I feel
Do you feel sure about the best choice for you?
Yes                No
 
 
Yes                No
Yes              No
 
 
Yes              No

 
If you answer 'yes' to all of the questions in an area, this shows you feel confident. People who have answered 'no' to one or several questions are more likely to delay their decision, to have trouble sticking with their choice, or to feel regret about their choice or less satisfied with their decision. Therefore, it is important to work through steps 4 and 5 to gain more confidence in each area.
 
4. Weigh the options
 What I know?
  1. Please list and review the options you are considering
  2. List the pros and cons of each option 
     
    PRO
    CONS
    Option #1 is:
     
     
     
    Option #2 is:
     
     
     
    Option #3 is:
     
     
     
 What is important to me?
 
How sure I feel?
 
How others help me?
 
Complete the table below to keep track of others involved in this decision.
 
LIST THE PERSONS WHOSE HELP OR OPTIONS MATTER TO YOU
THINGS THAT THEY CAN DO TO HELP YOU IN THIS DECISION
1.
 
2.
 
3.
 
 
5. Plan the next steps
 
THINGS MAKING THE DECISION DIFFICULT
THINGS YOU ARE WILLING TO TRY
Not enough information about options, pros and cons
Having enough information makes if easier to participate in decision-making:
 
  • List your questions.
 
  • List the sources you will use to find this information (e.g., health-care professionals, librarians at a health centre, internet, etc.)
 
Not enough information about the likelihood of the pros and cons
People make decisions based on their perception of what might happen:
  • Get advice from your health-care professional or counselor about how likely the pros and cons are happen in your situation.
 
Unsure about which pros and cons are most important to me
Finding out what was most important to others who made this decision may help clarify what is important for you:
  • Talk to your health-care professional or councilor about other people who made this decision.
  • Review stories about others who made this decision (e.g., on the internet). Whose views match yours?
  • Talk with people you know who have gone through this decision. Please specify who:
_____________________________________________________
 
Lack of support of resources
Support from other people or groups can help your decision-making:
  • List the resources or practical help you still need.
  • Get advice from a professional you feel comfortable with.
  • Choose a trusted person who will help you work through the decision.
  • Being someone with you to medical or other appointments to take notes
Pressure from others to make
a specific choice
Focus on the opinions of people who matter in this decision:
  • Share your decision guide with others
  • Ask others to complete a guide themselves. Identify areas of agreement and differences. (People usually can agree on the facts, but may differ on what they value most. It is the person who will be most directly affected by the choice whose matter most).
  • Find a neutral person to help you and others to find solutions to the disagreement.
Other factors making the
decision difficult
List everything else you need to help you.
  
© 2004 O’Connor, Jacobsen, Stacey, University of Ottawa, Ottawa Health Research Institute, Canada. Used with permission from the Ottawa Hospital Research Institute.