Theme 6: “I need to explore my decision in a meaningful way”
Participants identified the need for the adapted OPDG and decision coach to facilitate the meaningful acquisition and use of information. While participants viewed themselves as making care decisions, they indicated that in typical care settings their role(s) and way(s) of making decisions went unacknowledged and were undermined by dominant systems and social norms. The coach played a strong role in tailoring the way in which the adapted OPDG was used to foster respectful decision making processes. For instance, participants questioned the system for rating option preferences that involved scoring the values of options in relation to each other (Section 2).Glenda described the dilemma: “I cannot put stars to
differentiate – they all mean a lot to me. I would want to talk about it instead.” Samantha also emphasized the
importance of a conversation with a decision coach rather than making relative rankings of options: “Without this
[coachparticipant] conversation...this paper is just ‘do you want to do this or that’ – not the ‘why’”. These responses showed that it was undesirable for users to quantify the meanings attached to different options along with their pros and cons. Participants preferred to focus on talking through the meanings of options with the coach. When used in this new format, the participants affirmed that the adapted OPDG fostered respect for their preferred approach to decision making.