Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma

Abstract

Objective To identify determinants of shared decision making in patients with multiple myeloma (MM) to facilitate the design of a program to maximize the effects of shared decision making. Methods This prospective longitudinal study recruited 276 adult patients (52% male, mean age 62.86 y, SD 15.45). Each patient completed the eHealth Literacy Scale (eHEALS), Multidimensional Trust in Health Care Systems Scale (MTHCSS), Patient Communication Pattern Scale (PCPS), and 9‐Item Shared Decision‐Making Questionnaire (SDM‐Q‐9) at baseline and the SDM‐Q‐9 again 6 months later. One family member of the patient completed the Family Decision‐Making Self‐Efficacy (FDMSE) at baseline. Structural equation modeling (SEM) was used to investigate the associations between eHealth literacy (eHEALS), trust in the health care system (MTHCSS), self‐efficacy in family decision making (FDMSE), patient communication pattern (PCPS), and shared decision making (SDM‐Q‐9). Results SEM showed satisfactory fit (comparative fit index = 0.988) and significant correlations between the following: eHealth literacy and trust in the health care system (β = 0.723, P < 0.001); eHealth literacy and patient communication pattern (β = 0.242, P < 0.001); trust in the health care system and patient communication pattern (β = 0.397, P < 0.001); self‐efficacy in family decision making and patient communication pattern (β = 0.264, P < 0.001); eHealth literacy and shared decision making (β = 0.267, P < 0.001); and patient communication pattern and shared decision making (β = 0.349, P < 0.001). Conclusions Patient communication and eHealth literacy were found to be important determinants of shared decision making. These factors should be taken into consideration when developing strategies to enhance the level of shared decision making.

Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study

“…Although our literature search did not reveal papers reporting the association between PREM and eHealth literacy, several studies explored the effect of eHealth literacy (measured with the eHEALS instrument) on aspects of people-centered care such as the patient–physician relationship. A study among Iranian patients with multiple myeloma found a positive relationship between eHealth literacy and shared decision making, where eHealth literacy had a direct positive influence on shared decision making and an indirect positive effect mediated by collaborative patient communication patterns and trust in the health care system [ 37 ]. In a large survey among the Israeli general population, higher eHealth literacy score was associated with a more extensive interaction and a more balanced power position vis-à-vis with the treating physician [ 22 ].…”

“…Online health information may enhance the patient–physician relationship and although the evidence is mixed [ 32 , 33 ], the importance of eHealth literacy in translating the benefits of innovative digital health solutions to better experiences of care has been recognized [ 34 - 36 ]. For example, positive relationship between eHealth literacy and shared decision making has been found [ 37 ] and its contribution to patients’ decision-making styles has been demonstrated [ 32 ]. However, to our knowledge, no studies have focused on the relationship between eHealth literacy and PREMs to date.…”

The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study

“…eHealth literacy, as an important concept rooted in the practice of patient-centered care, is increasingly suggested to be used to improve SDM in clinical practice. For example, Nejati et al [ 20 ] found that low levels of eHealth literacy can limit patients’ trust in the health care system and their communication patterns and are a barrier to patient participation in the decision-making process. As the global population becomes increasingly reliant on the internet to locate and obtain health information and services [ 21 , 22 ], patients and their caregivers struggle to possess adequate eHealth literacy to engage in the decision-making process.…”

“…For example, Car et al [ 23 ] pointed out that poor eHealth literacy limited patients’ ability to make decisions in medicine management. Netjati et al [ 20 ] also showed that lower levels of eHealth literacy are associated with poorer SDM among patients with multiple myeloma. However, in China, there is no evidence regarding the relationship between eHealth literacy and medical decision-making.…”

The Perception of Shared Decision‐Making in Hematology by Patients and Physicians Seems Satisfactory, but Important Steps are Still Ahead of Us

“…Only one study with myeloma patients measured SDM, but did not report the actual scores. 11 These limited data are insufficient for hematologists wishing to integrate SDM in clinical decision-making with patients, and more empirical information is needed to support them.…”