Methods
This study was implemented in the Republic of Moldova Republican Clinical Hospital from January 2017 to July 2019. Among the participants were adult patients with manifest strabismus who needed a surgical correction and, where more than one techniques was enforceable (simetry surgery, asimetric surgery, ajustable stitch) and their doctor. Patients were enrolled in this study if they met the following criteria: (1) 18 years and older, (2) a confirmed diagnosis of manifest strabismus through orthoptic examination, and (3) Romanian communicative skills and presented the written agreemnet. The exclusion criteria were as follows: (1) severe cognitive impairment and (2) study involvement disapproval. The patients were informed about the study by their healthcare provider. They were thoroughly informed and assured that refusing to participate would not affect their treatment in any way.
This study was conducted in accordance with the principles of the Helsinki Declaration. Board of Directors for Medical Ethics, State University of Medicine and Pharmacy ” Nicolae Testemitanu” approved the study.
All patients underwent a detailed ocular examination and orthoptic evaluation before being subjected to strabismus surgery.
Before the study, patients basic demographic data on age, gender, diagnosis and number of consulation needed to reach a joint patient - doctor decision were registered. After the final consultation the patients completed the SDM-Q-9 questionnaire. In this previously approved questionnaire, the SDM level is assessed subjectively by evaluating the nine phases of the decision-making process from the patient’s perspective on a 6-point Likert scale ranging from 0 (not at all) to 5 (fully applicable). The doctor also filled out the SDM-Q-Doc questionnaire immediately after the consultation. This questionnaire was developed to measure the behavior of SDM from a doctor’s perspective and addresses the same problems as SDM-Q-9 for patients14. Romanian version had good internal consistency with 0.96 as the Cronbach α coefficient 18.
After treatment, patients were asked to rate their satisfaction with the surgical outcome as excellent, good, fair, and bad using the Face-Q scale (a 4-point scale)19. Fig. 1