Patient participation in decision-making

Guadagnoli, Edward; Ward, Patricia

doi:10.1016/s0277-9536(98)00059-8

Cited by 697 publications

(512 citation statements)

References 52 publications

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“…Hospital doctors' advice also had an influence on GP's decision to refer these patients to genetics (Al-Habsi et al 2008). The effects of doctors' advice on patients' participation in healthcare decisionmaking had been reviewed (Guagdognoli and Ward 1998). Thus, patients consulted their GPs not necessarily because they believe their family history of cancer could increase that risk.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care

et al. 2011

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Patient self-initiated consultations to discuss family history of cancer in primary care and the factors leading to these consultations have not been investigated. Seventy-one out of 150 asymptomatic patients with a family history of cancer at the Yorkshire Cancer Genetics Service participated in this study. A semi-structured questionnaire was administered. The results show that (1) family cancer events, doctors' advice and reaching the age of cancer-affected relatives were more salient in raising awareness of the added cancer risk due to family history than media and publicity, and knowledge of the genetics services; (2) knowledge of family medical history and its clinical value is not easy to ascertain; (3) the interrelationships with other causal beliefs are of interest and could provide insights to understand the factors motivating patients to discuss family history or cancer risk; (4) the belief that 'cancer runs in the family' or is 'a family thing' may not be sufficient to heighten perceived cancer risk and motivate patients to seek medical advice; and (5) understanding of the medical concept and clinical value of family history is poor even in this group of patients who initiated the GP consultations. In conclusion, because most primary care practitioners are likely to rely on patient initiated discussion to identify individuals at an increased risk of cancer because of their family history, these findings are therefore important to help doctors and health providers understand the reasons influencing asymptomatic patients to self-refer themselves in primary care and discuss cancer risk in order to provide appropriate care.

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Section: Discussionmentioning

confidence: 99%

Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care

et al. 2011

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“…Researchers report that a client-centred approach leads to improved outcomes, such as shorter hospital stays, reduced symptoms, reduced anxiety, greater sense of control and satisfaction, better goal attainment, greater adherence to treatment plans, and statistically and clinically significant gains in clients' abilities to perform or direct selfcare and community living skills. [75][76][77][78][79] Moreover, time and resources are optimized when attention is focused on those issues of greatest importance to the client. 80 Although it might be argued that institutional demands for rapid throughputs and standardized efficiencies can militate against an individualized, needs-led approach to rehabilitation for people with SCI, the fact that the participants in the reviewed studies cited so many examples of practice excellence suggests that accountability and compassion are not inherently incompatible.…”

Section: Discussionmentioning

confidence: 99%

Experience of rehabilitation following spinal cord injury: a meta-synthesis of qualitative findings

Hammell¹

2007

Spinal Cord

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Study design: Meta-synthesis of qualitative research. Objectives: To identify, compare and synthesize published qualitative evidence concerning the experience of rehabilitation following spinal cord injury (SCI). Methods: Published articles were identified from the Medline, CINAHL and Sociological abstracts databases, a hand search through selected journals published since 1990, and from reference lists. These were assessed for their relevance to the focus of interest and appraised for rigour. The key themes that emerged from the data were summarized, compared and synthesized. Results: The search located 64 papers and four books, of which eight papers (describing seven studies) met the review criteria for relevance and rigour. Thematic comparison and synthesis resulted in the identification of seven concepts that encapsulate the important dimensions of rehabilitation from participants' perspectives: (1) the importance of specific staff qualities; (2) the need for a vision of future life possibilities; (3) the importance of peers; (4) the relevance of programme content; (5) the institutional context of rehabilitation; (6) the importance of reconnecting the past to the future; (7) the importance of meeting the needs of the real world. Conclusions: If rehabilitation services are to be evidence-based, relevant and effective in meeting the needs of people with SCI they must be informed by the perspectives of people with SCI. The findings of this review suggest that the most important dimension of rehabilitation for people with SCI is the calibre and vision of the rehabilitation staff.

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“…There is evidence that shared decision-making brings a range of physical and psychological benefits for patients [1][2][3]. Offering choice is one way in which clinicians can attempt to realise these benefits.…”

Section: Introductionmentioning

confidence: 99%

Offering patients choices: A pilot study of interactions in the seizure clinic

Toerien

Shaw

Duncan

et al. 2011

Epilepsy & Behavior

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Using Conversation Analysis (CA), we studied conversations between one UK-based epilepsy specialist and thirteen seizure patients in whom there was uncertainty about the diagnosis, and for whom different treatment and investigational options were being considered. In line with recent communication guidance, the specialist offered some form of choice to all patients: in eight cases, a course of action was proposed, to be accepted or rejected, and in the remaining five a "menu" of options was offered. Even when presenting a menu, the specialist sometimes conveyed his own preferences in how he described the options, and in some cases the menu was used for reasons other than offering choice (e.g. to address patient resistance). Close linguistic and interactional analysis of clinical encounters can show why doctors may feel they are offering choices when patients report that the decision was clinician-dominated.

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Patient participation in decision-making

Cited by 697 publications

References 52 publications

Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care

Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care

Experience of rehabilitation following spinal cord injury: a meta-synthesis of qualitative findings

Offering patients choices: A pilot study of interactions in the seizure clinic

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