Decision Coaching to Support Shared Decision Making: A Framework, Evidence, and Implications for Nursing Practice, Education, and Policy

Stacey, Dawn; Murray, Mary; Légaré, France; Dunn, Sandy; Menard, Prudy; O’Connor, Annette M.

doi:10.1111/j.1741-6787.2007.00108.x

Cited by 154 publications

(145 citation statements)

References 34 publications

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“…Guidelines for client-centred care make explicit the importance of including patient preferences in the decision-making process and of supporting the participation of patients in decision-making (possibly facilitated by decision coaches) 2,3,31 . However, research indicates that current practice among health professionals is inadequate and that these professionals need supportive environments that provide opportunities for them to further develop their knowledge and skills for supporting patient involvement in decision-making 11,20,32 .…”

Section: Discussionmentioning

confidence: 99%

Exploring Cancer Treatment Decision-Making by Patients: A Descriptive Study

2010

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ObjectiveUsing an interview-guided survey, our descriptive study aimed to document the extent to which cancer patients perceive they are involved in making treatment decisions and the factors that influence patient involvement. Patients and methodsOur study enrolled patients from a Canadian ambulatory oncology program who were undergoing chemotherapy or radiation therapy, or both, for cancer. The adapted Control Preferences Scale was used to survey perceived and preferred roles in decisionmaking. The study survey also included items from the Decisional Conflict Scale and the Preparation for Decision-Making Scale. ResultsOf 192 participants, 98 (51%) perceived that they were offered treatment choices. Of those 98, 47 (48%) thought that the options were presented equally. Compared with the patients not offered choices, those who were given choices were less passive (4% vs. 29%, p < 0.001) and more satisfied (100% vs. 95%, p < 0.03) in decision-making. Participants whose preferred and perceived roles were different would have preferred more involvement in decision-making. To attain the preferred involvement, patients wanted to receive more information on treatment options, to be given a choice, to have more discussion with the health care team, and to have providers better listen to their needs. ConclusionsOnly half of surveyed patients thought that they were offered choices for their cancer treatment. When offered choices, patients were more active in decisionmaking. Further initiatives are required to determine approaches for supporting patients with cancer so that they can be more involved in decision-making.

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Section: Discussionmentioning

confidence: 99%

Exploring Cancer Treatment Decision-Making by Patients: A Descriptive Study

2010

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“…Finalmente, es importante resaltar que los profesionales de la salud deben ser formados en las habilidades que les permitan apoyar a los pacientes y sus familias en la toma de decisiones en salud, lo que puede ser fomentado a través de intervenciones dirigidas específicamente a enfermeras, pero también debe estar incorporado en las instituciones donde se forman y en las cuales se desempeñan estos profesionales (20).…”

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Initial Validation of an Analytical Tool to Support Decision-making on Chronic Illness Management

et al. 2013

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Introducción: el apoyo a la toma de decisiones en salud facilita el automanejo de personas con enfermedades crónicas (EC). Ob- jetivo: validar la versión en español del DSAT-cdm: herramienta de análisis del apoyo en las decisiones para el manejo de EC, desa- rrollada por Stacey (2006). Materiales y métodos: estudio descriptivo que aplica un proceso sistemático que considera, entre otros: traducción-contratraducción, desarrollo de escenarios de simulación, entrenamiento de evaluadores, entrenamiento pacientes simulados y capacitación para participantes. Muestra: 15 profesionales y 2 jueces, obteniéndose 60 DSAT-cdm versión español aplicado (pre y pos capacitación). Resultados: el instrumento presentó confiabilidad aceptable en la aplicación entre-jueces y detectó la mejora en la calidad del apoyo a la toma de decisiones en los profesionales. Sin embargo, no se obtuvieron resultados que aportaran a la validez de criterio concurrente. Conclusiones: este estudio es la primera evaluación del DSAT-cdm en idioma español, el resultado principal indica que se detecta un cambio en el desempeño de profesionales para apoyar el proceso de toma de decisiones de sus pacientes y, a pesar estos hallazgos favorables, es necesario seguir evaluando el instrumento.

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“…Research in PtDA implementation recommends the involvement of a decision coach, who may be a nurse, a pharmacist, or a rehabilitation professional, to counsel the patient while using a PtDA (34,35). Stacey et al (35) describe decision coaching as a 4-step process that involves: 1) assessing patients' knowledge needs and clarity in treatment preferences; 2) facilitating patients' use of decision aids, verifying their understanding about the content, clarifying their preferences, and building communication skills; 3) monitoring their progress in decisionmaking; and 4) screening for factors that influence the implementation of their decisions. The ultimate goal is to assist patients in reaching a decision that is right for them.…”

Section: Discussionmentioning

confidence: 99%

Rheumatologists’ Views and Perceived Barriers to Using Patient Decision Aids in Clinical Practice

Zong

Leese

Klemm

et al. 2015

Arthritis Care & Research

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Objective. To explore rheumatologists' perceptions of patient decision aids (PtDAs) and identify barriers to using them in clinical practice. Methods. A cross-sectional online survey of all members of the Canadian Rheumatology Association (CRA; n 5 459) was conducted. We subsequently invited 10 respondents to participate in a 30-minute telephone interview to further explore their views on using PtDAs in clinical practice. Interview participants were purposefully sampled to achieve a balance in sex, years in clinical practice, and types of practice. Results. In August and September 2013, 153 CRA members responded to the survey (response rate 33.3%); of those, 113 completed the entire questionnaire. Sixty-three respondents (55.8%) were male, 54 (47.8%) were ‡50 years of age, and 55 (48.7%) practiced in a multidisciplinary setting. When asked about their intention to use PtDAs, participants rated mean 6 SD 5.7 6 2.9 (where 0 5 not likely and 10 5 very likely). Sixty-four (56.6%) believed that rheumatologists were unfamiliar with PtDAs, and 76 (67.3%) thought that PtDAs would disturb their workflow. In-depth interviews revealed the following: the perception that PtDAs were no different from any other patient education tools, the concern that PtDAs were of limited value in real life since they relied solely on data from randomized controlled trials, and the fear that PtDAs could impair doctor-patient communication.Conclusion. There was a sense of ambivalence among rheumatologists about PtDAs. Our interviews further revealed concerns regarding the utility and benefits of PtDAs in clinical practice. The results show a need to familiarize physicians with PtDAs and to develop strategies to support their integration in clinical practice.

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Decision Coaching to Support Shared Decision Making: A Framework, Evidence, and Implications for Nursing Practice, Education, and Policy

Cited by 154 publications

References 34 publications

Exploring Cancer Treatment Decision-Making by Patients: A Descriptive Study

Exploring Cancer Treatment Decision-Making by Patients: A Descriptive Study

Initial Validation of an Analytical Tool to Support Decision-making on Chronic Illness Management

Rheumatologists’ Views and Perceived Barriers to Using Patient Decision Aids in Clinical Practice

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