Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Blair, Louisa

doi:10.1007/s40271-015-0117-0

Cited by 35 publications

(26 citation statements)

References 47 publications

(44 reference statements)

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“…Nowadays, patients' role in health-and treatment-related decision-making has started to change in the direction of shared decision-making (Blair & Légaré, 2015). This is due to a number of reasons such as the increase of long-term conditions, unlimited access to information outside of the hospital setting, expectations for patient autonomy in medical decisions, availability of more than one treatment option, and acknowledgement of patient preferences and values (Woolf et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

The Role of Illness Perceptions on Health-Related Decision-Making—A Focus Group Study of Patients with Long-Term Conditions

Nielsen¹,

Lomborg²

2017

PSYCH

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Facing long-term conditions, patients often find themselves in situations where they need to make health-related decisions. The aim of this study was to gain a better understanding of patient preferences for involvement in decision-making as well as the process of decision-making both inside and outside the hospital setting. Seventeen participants with various long-term somatic conditions and different types of treatment regimens participated in this focus group study. Preference for involvement in decision-making was quantitatively measured prior to the interviews using the Control Preference Scale. To obtain the qualitative data, an interpretive description strategy was used. The Self-Regulation Model of illness perceptions was applied as a conceptual framework for discussing the findings. A number of discrepancies between questionnaire-and interview data were discovered, indicating that cognitive beliefs about personal involvement in decision-making are influenced and changed by emotions as well as a number of contextual actors, including personal values concerning everyday quality of life. This study provides insight into understanding how context influences self-regulation of health related decisions amongst patients with a number of long-term conditions. Moreover, decisions are not isolated events, they evolve over time. Thus, data on patients' desired level of involvement in decisions based on questionnaire responses alone should be interpreted with caution. Healthcare providers may benefit from exploring the patients' illness representation in the decision process and thus reduce the risk of talking at cross-purposes.

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Section: Introductionmentioning

confidence: 99%

The Role of Illness Perceptions on Health-Related Decision-Making—A Focus Group Study of Patients with Long-Term Conditions

Nielsen¹,

Lomborg²

2017

PSYCH

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“…This demand for patient decision aids is part of a larger paradigm shift from doctor-centric decision making to shared decisions with patients which is achievable if effective implementation interventions such as patient decision aids are used [5]. Patient decision aids make explicit the decision, provide high-quality evidence on the outcomes of options including watchful waiting, and help patients clarify what is important to them based on their personal circumstances [6].…”

Section: Introductionmentioning

confidence: 99%

Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype

Stacey

Lyddiatt²,

Giguère

et al. 2016

Patient

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AimThe purpose of this study was to translate evidence from Cochrane Reviews into a format that can be used to facilitate shared decision making during the consultation, namely patient decision aids.MethodsA systematic development process (a) established a stakeholder committee; (b) developed a prototype according to the International Patient Decision Aid Standards; (c) applied the prototype to a Cochrane Review and used an interview-guided survey to evaluate acceptability/usability; (d) created 12 consult decision aids; and (e) used a Delphi process to reach consensus on considerations for creating a consult decision aid.ResultsThe 1-page prototype includes (a) a title specifying the decision; (b) information on the health condition, options, benefits/harms with probabilities; (c) an explicit values clarification exercise; and (d) questions to screen for decisional conflict. Hyperlinks provide additional information on definitions, probabilities presented graphically, and references. Fourteen Cochrane Consumer Network members and Cochrane Editorial Unit staff participated. Thirteen reported that it would help patient/clinician discussions and were willing to use and/or recommend it. Seven indicated the right amount of information, six not enough, and one too much. Changes to the prototype were more links to definitions, more white space, and details on GRADE evidence ratings. Creating 12 consult decision aids took about 4 h each. We identified ten considerations when selecting Cochrane Reviews for creating consult decision aids.ConclusionsUsing a systematic process, we developed a consult decision aid prototype to be populated with evidence from Cochrane Reviews. It was acceptable and easy to apply. Future studies will evaluate implementation of consult decision aids.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-016-0177-9) contains supplementary material, which is available to authorized users.

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“…But SDM is difficult to apply in practice (Elwyn et al 2012; Blair and Légaré 2015) and some patients take on a passive role in the decision-making (Tariman et al 2010; Petriwskyj et al 2014). This is due to multiple barriers to do with the patient, the healthcare professionals and the institutional framework (Légaré et al 2006; Frosch and Elwyn 2014; Joseph-Williams et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Information provision and attentive listening as determinants of patient perceptions of shared decision-making around chronic illnesses

et al. 2016

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BackgroundWhile chronic illnesses are a major concern of the health system worldwide, little is known about patients–physicians communication. Growing demand for patient-centered care and shared decision-making have increased the interest for patients–physicians communication. Based on previous literature, we propose a model in which the effect of information provision and attentive listening over patients’ perceptions of shared decision-making (PPSDM) is mediated by the variables self-efficacy and proactivity. Primary data were collected between April and August 2014 through an online survey of patients with haemophilia. Haemophilia is a chronic disease in which many options of treatment are available. The right option depends, to some extent, on patient’s preferences. In this context, great uncertainty exists when choosing treatment option and shared decision-making plays an essential role.ResultsA total of 181 patients with haemophilia participated in the survey. The psychometric properties of the measurement scales were evaluated by means of a confirmatory factor analysis. A structural equation model was designed. Results show that provision of information and attentive listening determine PPSDM through patients’ self-efficacy and proactivity in requesting information.ConclusionsIt is important to incorporate communication training in medical education, particularly provision of information and attentive listening. These skills help the healthcare professional to gain a deeper understanding of the patient. Furthermore, provision of information and attentive listening are fundamental in helping patients not to undervalue their personal knowledge and expertise in relation to their doctors. These strategies encourage them to adopt a more active position in requesting information. Encouraging a proactive behaviour of patients and their relatives helps them to realize the need to participate and to make them feel that they are part of the decision-making process.

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Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Cited by 35 publications

References 47 publications

The Role of Illness Perceptions on Health-Related Decision-Making—A Focus Group Study of Patients with Long-Term Conditions

The Role of Illness Perceptions on Health-Related Decision-Making—A Focus Group Study of Patients with Long-Term Conditions

Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype

Information provision and attentive listening as determinants of patient perceptions of shared decision-making around chronic illnesses

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