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

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.

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

American Journal of Occupational Therapy ◽

10.5014/ajot.2021.75s2-rp247 ◽

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

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Abstract B77: Shared decision-making and mammography screening: A national sample

10.1158/1538-7755.disp13-b77 ◽

2014 ◽

Author(s):

Christine M. Gunn ◽

Marina Soley-Bori ◽

Tracy A. Battaglia

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Mammography Screening ◽

National Sample ◽

Shared Decision

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

10.1093/med/9780198736134.003.0004 ◽

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.

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