Shared Decision-Making and the Lower Literate Patient

2004 ◽  
Vol 32 (4) ◽  
pp. 759-764 ◽  
Author(s):  
David I. Shalowitz ◽  
Michael S. Wolf
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Medical Literature ◽  
Informed Choice ◽  
Shared Decision ◽  
Health Care Needs ◽  
Care Needs ◽  
Ideal Method ◽  
The Ideal

In recent years, shared decision-making has become entrenched in the medical literature and the law as the ideal method for involving patients in decisions related to their health care. Shared decision-making represents a compromise between the opposed extremes of paternalistic interactions that limit patients’ control of their health care, and “informed choice” interactions that require physicians to provide technical expertise only, leaving patients to make all treatment decisions on their own. An implicit goal of shared decision-making is to improve medical care by promoting joint participation of patients and physicians in clinical consultations. The model of shared decision-making may, however, inadequately address the health care needs of lower literate patients, a significant portion of the general population.As shared decision-making is widely held as a clinical ideal, we highlight the difficulties that physicians might have in implementing shared decision-making with lower literate patients.

scholarly journals Shared Decision-Making and Health Care Expenditures Among Children With Special Health Care Needs

PEDIATRICS ◽  
2011 ◽  
Vol 129 (1) ◽  
pp. 99-107 ◽  
Author(s):  
A. G. Fiks ◽  
S. Mayne ◽  
A. R. Localio ◽  
E. A. Alessandrini ◽  
J. P. Guevara
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Expenditures ◽  
Special Health Care Needs ◽  
Shared Decision ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Special Health

scholarly journals Disparities in Shared Decision Making and Service Receipt Among Children With Special Health Care Needs and Developmental Delay: A National Survey Analysis

2020 ◽  
Vol 11 ◽  
pp. 215013272092458
Author(s):  
Monica Perez Jolles ◽  
Leah L. Zullig ◽  
Pey-Jiuan Lee ◽  
Gauri Kolhatkar
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Service Use ◽  
Special Health Care Needs ◽  
Shared Decision ◽  
Health Care Needs ◽  
Care Providers ◽  
Care Needs ◽  
Special Health Care ◽  
Special Health

Shared decision making (SDM) is associated with increased service satisfaction among pediatric patients. Our objective was to examine the association between SDM and service use experiences across racial/ethnic child groups. This secondary data analysis used the 2009-2010 National Survey of Children with Special Health Care Needs (CSHCN) and 2011 Pathways to Diagnosis and Services Survey. We used a rank-and-replace matching approach consistent with Institute of Medicine recommendations for health disparities research. We included CSHCN aged 6 to 17 years. The exposure of interest was parents of CSHCN reporting engagement in SDM with clinicians. There were 4032 CSHCN included in analysis. CSHCNs experiencing SDM had a 16% higher probability of reporting service use compared to those not experiencing it (95% CI, 14.24-19.42). Black children experiencing SDM reported seeing all needed care providers at a lower rate than whites (79% and 87.6% respectively; 95% CI, -14.05-3.27). The benefit of SDM over not experiencing it for blacks was 12.2% less than for whites for the outcome of seeing all needed care providers. For the outcome of receiving all needed treatments and services, the SDM benefit was 9.1% lower for Hispanics compared with whites. SDM can improve service experiences but implementation flexibility may be needed.

Health Decisions and Decision Support for Women

2001 ◽  
Vol 19 (1) ◽  
pp. 307-324 ◽  
Author(s):  
MARILYN L. ROTHERT ◽  
ANNETTE M. O’CONNOR
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Cochrane Review ◽  
Informed Choice ◽  
Shared Decision ◽  
Patient Decision ◽  
Key Issues ◽  
Conceptual Overview

Women are more likely to live longer with chronic illness and have a longterm relationship with their health care provider; this requires a situation in which patients and providers have a role in managing illness. In this chapter, the authors provide a conceptual overview of decision making along with key issues: historical concepts related to patients and providers, consumerism, informed choice/consent, patient rights, shared decision making, patient involvement, as well as an overview of models of patient/provider partnerships. This review builds on the work of O’Connor et al. (1999), which resulted in a Cochrane review of decision aids and focuses the examination of patient decision aids that support women’ decisions regarding health treatment or screening. The authors conclude with a look to the future and recommendations for research in the area of shared decision making and health care decision aids.

scholarly journals Shared decision making and behavioral impairment: a national study among children with special health care needs

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Alexander G Fiks ◽  
Stephanie Mayne ◽  
A Russell Localio ◽  
Chris Feudtner ◽  
Evaline A Alessandrini ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Special Health Care Needs ◽  
National Study ◽  
Shared Decision ◽  
Health Care Needs ◽  
Care Needs ◽  
Behavioral Impairment ◽  
Special Health Care ◽  
Special Health

scholarly journals Using argumentation theory to identify the challenges of shared decision-making when the doctor and the patient have a difference of opinion

2012 ◽  
Vol 1 (2) ◽  
pp. 26 ◽  
Author(s):  
Claudia A. Zanini ◽  
Sara Rubinelli
Keyword(s):  
Decision Making ◽  
Dispute Resolution ◽  
Shared Decision Making ◽  
Communication Skills ◽  
Critical Discussion ◽  
Argumentation Theory ◽  
Shared Decision ◽  
Ideal Model ◽  
Difference Of Opinion ◽  
The Ideal

This paper aims to identify the challenges in the implementation of shared decision-making (SDM) when the doctor and the patient have a difference of opinion. It analyses the preconditions of the resolution of this difference of opinion by using an analytical and normative framework known in the field of argumentation theory as the ideal model of critical discussion. This analysis highlights the communication skills and attitudes that both doctors and patients must apply in a dispute resolution-oriented communication. Questions arise over the methods of empowerment of doctors and patients in these skills and attitudes as the preconditions of SDM. Overall, the paper highlights aspects in which research is needed to design appropriate programmes of training, education and support in order to equip doctors and patients with the means to successfully engage in shared decision-making.

A survey of health care practitioners’ attitudes toward shared decision‐making for choice of next birth after cesarean

Birth ◽  
2021 ◽  
Author(s):  
Sarah Munro ◽  
Elizabeth S. Wilcox ◽  
Leah K. Lambert ◽  
Monica Norena ◽  
Sarah Kaufman ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Health Care Practitioners

scholarly journals “They Should Be Asking Us”: A Qualitative Decisional Needs Assessment for Women Considering Cervical Cancer Screening

2018 ◽  
Vol 5 ◽  
pp. 233339361878363 ◽  
Author(s):  
Brianne Wood ◽  
Virginia L. Russell ◽  
Ziad El-Khatib ◽  
Susan McFaul ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Shared Decision Making ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Hpv Testing ◽  
Shared Decision ◽  
Care Providers

In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.

Sign in / Sign up

Export Citation Format

Share Document