The social construction of the patient-physician relationship in the clinical encounter: Media frames on shared decision making in Germany

2021 ◽  
pp. 114420
Author(s):  
Amyn Vogel ◽  
Daniel Fürstenau ◽  
Felix Balzer
Keyword(s):  
Decision Making ◽  
Social Construction ◽  
Shared Decision Making ◽  
Clinical Encounter ◽  
Shared Decision ◽  
Media Frames ◽  
The Social ◽  
Physician Relationship

Observer Ratings of Shared Decision Making Do Not Match Patient Reports: An Observational Study in 5 Family Medicine Practices

2020 ◽  
Vol 41 (1) ◽  
pp. 51-59
Author(s):  
Gisèle Diendéré ◽  
Imen Farhat ◽  
Holly Witteman ◽  
Ruth Ndjaboue
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Risk Communication ◽  
Shared Decision Making ◽  
Cross Sectional Study ◽  
Clinical Encounter ◽  
Values Clarification ◽  
Shared Decision ◽  
Cross Sectional ◽  
Medical Consultations

Background Measuring shared decision making (SDM) in clinical practice is important to improve the quality of health care. Measurement can be done by trained observers and by people participating in the clinical encounter, namely, patients. This study aimed to describe the correlations between patients’ and observers’ ratings of SDM using 2 validated and 2 nonvalidated SDM measures in clinical consultations. Methods In this cross-sectional study, we recruited 238 complete dyads of health professionals and patients in 5 university-affiliated family medicine clinics in Canada. Participants completed self-administered questionnaires before and after audio-recorded medical consultations. Observers rated the occurrence of SDM during medical consultations using both the validated OPTION-5 (the 5-item “observing patient involvement” score) and binary questions on risk communication and values clarification (RCVC-observer). Patients rated SDM using both the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and binary questions on risk communication and values clarification (RCVC-patient). Results Agreement was low between observers’ and patients’ ratings of SDM using validated OPTION-5 and SDM-Q9, respectively (ρ = 0.07; P = 0.38). Observers’ ratings using RCVC-observer were correlated to patients’ ratings using either SDM-Q9 ( rpb = −0.16; P = 0.01) or RCVC-patients ( rpb = 0.24; P = 0.03). Observers’ OPTION-5 scores and patients’ ratings using RCVC-questions were moderately correlated ( rφ = 0.33; P = 0.04). Conclusion There was moderate to no alignment between observers’ and patients’ ratings of SDM using both validated and nonvalidated measures. This lack of strong correlation emphasizes that observer and patient perspectives are not interchangeable. When assessing the presence, absence, or extent of SDM, it is important to clearly state whose perspectives are reflected.

Improving the Perception of Patient-Centered Wellness in a Virtual Population During the COVID-19 Pandemic

2021 ◽  
pp. JDNP-D-20-00078
Author(s):  
Sybilla Myers ◽  
Christopher Kennedy
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Shared Decision Making ◽  
Cognitive Theory ◽  
Well Being ◽  
Mobile App ◽  
Shared Decision ◽  
Patient Centered ◽  
The Social

BackgroundPerceived health-related quality of life (HRQOL) is fundamental to well-being and is a meaningful way to measure physical and mental health.Local ProblemNo standard method exists for measuring perceived HRQOL during the COVID-19 pandemic in participants as they attempt to improve their self-determined wellness goals. An implementation plan that considers the social distancing limitations imposed can be used to predict an individual’s likelihood of long-term success.MethodsDuring the four, 2-week plan-do-study-act (PDSA) cycles, the Social Cognitive Theory model informed the implementation of the four core interventions. To guide iterative changes, the data was analyzed through Excel and run charts.InterventionsThe four core interventions were the shared decision-making tool (SDMT), health mobile app tool (HMAT), wellness tracker tool (WTT), and the team engagement plan.ResultsAmong 28 participants, perceived quality of life increased by 70%, engagement in shared decision-making increased to 82%, app use and confidence increased to 85%, and goal attainment reached 81%.ConclusionsThe SDMT, health app, and wellness tracker created a methodical plan of accountability for increasing participant wellness. The contextual barrier of the COVID-19 pandemic added a negative wellness burden which was mitigated by creating a patient-centered culture of wellness.

Exploring Shared Decision Making Between Family Caregivers, Persons With Disorders of Consciousness, and Rehabilitation Therapists in Acute Care

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510247p1-7512510247p1
Author(s):  
Jennifer Weaver ◽  
Trudy Mallinson ◽  
Leslie Davidson ◽  
Christina Papadimitriou ◽  
Ann Guernon ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Caregivers ◽  
Shared Decision Making ◽  
Research Study ◽  
Medical Model ◽  
Clinical Encounter ◽  
Disorders Of Consciousness ◽  
Observational Research ◽  
Shared Decision ◽  
Clinical Encounters

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This qualitative, observational research study explored treatment encounters between patients with disorders of consciousness, rehabilitation practitioners, and family to understand how treatment decisions occurred. The data showed shared decision making (SDM) occurring as a process, meaning that not all five principles of SDM occur in one clinical encounter but rather unfold across multiple clinical encounters. We delineate differences in SDM between rehabilitation and the medical model. Primary Author and Speaker: Jennifer Weaver Contributing Authors: Trudy Mallinson, Leslie Davidson, Christina Papadimitriou, Ann Guernon, and Philip van der Wees

Shared decision-making, decision aids, and the role of values in treatment decision-making

2017 ◽  
Author(s):  
Amiram Gafni ◽  
Cathy Charles
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Conceptual Development ◽  
Decision Aids ◽  
Treatment Decision ◽  
Clinical Encounter ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
Key Characteristics

Shared decision-making (SDM) between physicians and patients is often advocated as the ‘best’ approach to treatment decision-making in the clinical encounter. In this chapter we describe: (i) the key characteristics of a SDM approach; (ii) the clinical contexts for SDM; (iii) the definition and use of decision aids (DA), as well as their relationship to SDM; and (iv) the vexing problem of defining the meaning and role of values/preferences in treatment decision-making. Areas for further research and conceptual development are also suggested to help resolve outstanding issues in the above areas. Despite the widespread interest in promoting SDM, there does not seem to be as yet a universally accepted consensus on the meaning of this concept.

scholarly journals Framing the Clinical Encounter: Shared Decision-Making, Mammography Screening, and Decision Satisfaction

2020 ◽  
Vol 25 (9) ◽  
pp. 681-691
Author(s):  
Ellie F. Yang ◽  
Dhavan V. Shah ◽  
Elizabeth S. Burnside ◽  
Terry A. Little ◽  
Natalie Garino ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Mammography Screening ◽  
Clinical Encounter ◽  
Shared Decision ◽  
Decision Satisfaction

scholarly journals Shared decision-making allows subordinates to lead when dominants monopolize resources

2020 ◽  
Vol 6 (48) ◽  
pp. eaba5881
Author(s):  
Danai Papageorgiou ◽  
Damien R. Farine
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Dominance Hierarchy ◽  
Social Groups ◽  
Decision Makers ◽  
Shared Decision ◽  
Intragroup Conflict ◽  
The Social ◽  
Animal Societies

The concepts of leadership and dominance are often conflated, with individuals high in the social hierarchy assumed to be decision-makers. Dominants can exclusively benefit from monopolizing food resources and, therefore, induce an intragroup conflict when leading their group to these resources. We demonstrate that shared decision-making reduces such conflicts by studying movement initiations of wild vulturine guineafowl, a species that forms large, stable social groups with a steep dominance hierarchy. When dominant individuals displace subordinates from monopolizable food patches, the excluded subordinates subsequently initiate collective movement. The dominants then abandon the patch to follow the direction of subordinates, contrasting with nonmonopolizable resources where no individuals are excluded, and dominant individuals contribute extensively to group decisions. Our results demonstrate the role of shared decision-making in maintaining the balance of influence within animal societies.

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