Shared Decision Making during the COVID-19 Pandemic

Abstract

Objective The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals’ attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic. Methods We conducted an online survey with a large convenience sample ( N = 1061). Our main measures of interest were participants’ generic and COVID-19–related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants’ health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance. Results In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19–related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19–related participation preferences predicted lower triage acceptance. Conclusion Our findings demonstrate potential health care recipients’ attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.

Different patients, different preferences: A multicenter assessment of patients' personality traits and anxiety in shared decision making

“…While this leaves a large proportion of variance unaccounted for, participation preference is a multifaceted phenomenon, and one cannot expect a single factor to explain large proportions of variance. Moreover, our results replicate recent findings on anxiety and participation preference for COVID‐19 related decision making 13 …”

Decision Conflicts in Clinical Care during COVID-19: A Patient Perspective

“…Interestingly, lower school education was related to fewer decisional disturbances. This observation was similarly reported by Cona et al [ 26 ] targeting pandemic-related risks, and by Köther et al [ 11 ] investigating decision participation preferences.…”

“…As a consequence, the pandemic induced a need for adapted criteria for SDM processes [ 10 ], but investigations aiming at patients’ attitudes towards SDM and predictors of decisional preferences during the pandemic are very rare [ 11 , 12 ]. For example, qualitative analyses by Edge et al [ 13 ] and Butow et al [ 14 ] showed pandemic-related SDM vulnerability of specific patient groups, such as in oncology, characterized by psychological distress, fear of virus susceptibility, practical issues in daily life, disruptions to treatment and services, information needs, and caregiver issues.…”

Lessons Learned From the COVID-19 Pandemic as Experienced by Older Adults Treated for COVID-19

“…Several studies emphasised the importance of SDM in relation to COVID-19; however, the older adults in our study experienced little involvement in decision making ( Cardona et al., 2020 ; Köther et al, 2021 ; Paladino et al, 2021 ; Simpson et al, 2020 ). This study confirms that when older adults are in acute poor condition, it is difficult to participate in SDM ( Dyrstad et al, 2015 ; Ekdahl et al, 2010 , 2011 ; Gauthier, 2005 ).…”