scholarly journals US-based cross-sectional survey of clinicians’ knowledge and attitudes about shared decision-making across healthcare professions and specialties

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022730 ◽  
Author(s):  
Rachel C Forcino ◽  
Renata West Yen ◽  
Maya Aboumrad ◽  
Paul J Barr ◽  
Danielle Schubbe ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Positive Attitudes

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.

scholarly journals Do socio-economically disadvantaged patients prefer shared decision-making?

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Owen O. Eales ◽  
Selma Smith
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Outpatient Clinic ◽  
Economically Disadvantaged ◽  
Median Income ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Family

Background: Shared decision-making is the process where patients and clinicians work together to make healthcare choices. When given a choice, most patients want to participate in decision-making about their treatment. There is a perception amongst clinicians that socio-economically disadvantaged patients do not want to participate in shared decision-making. This study investigated if patients visiting the Family Medicine Outpatient Clinic at Kalafong Hospital in Gauteng, South Africa, would prefer shared decision-making.Methods: Cross-sectional survey was performed using the Control Preference Scale. Patients visiting the Family Medicine Outpatient Clinic at Kalafong Hospital were purposively selected (n = 150) between February 2016 and May 2016.Results: The patients had a median age of 52 years and 53% did not finish grade 12 at school. Their median income was R3200.00 (South African Rand [ZAR]; less than $200.00) per month. Nearly half (46%) of the patients surveyed had an active preference for shared decision-making during a consultation. No demographic or disease factors had a statistically significant association with this preference.Conclusion: The perception that socio-economically disadvantaged patients do not want to actively participate in shared decision-making is incorrect according to this study. As it is not possible to predict which patients prefer an active approach to shared decision-making, it is recommended that clinicians should enquire whether they would prefer shared decision during consultations. Clinicians should also be equipped to practice this technique and an environment needs to be created that facilitates the process.

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.

scholarly journals Shared decision-making as a cost-containment strategy: US physician reactions from a cross-sectional survey

BMJ Open ◽  
2014 ◽  
Vol 4 (1) ◽  
pp. e004027 ◽  
Author(s):  
Jon C Tilburt ◽  
Matthew K Wynia ◽  
Victor M Montori ◽  
Bjorg Thorsteinsdottir ◽  
Jason S Egginton ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Cost Containment ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Containment Strategy

scholarly journals Patient autonomy in dental medical decision making – demonstrating the need for shared decision making

2020 ◽  
Author(s):  
Mareike Benecke ◽  
Jürgen Kasper ◽  
Christoph Heesen ◽  
Nina Schäffler ◽  
Daniel Reissmann
Keyword(s):  
Multiple Sclerosis ◽  
Decision Making ◽  
General Practice ◽  
Shared Decision Making ◽  
Treatment Decisions ◽  
Medical Decision ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Study Results

Abstract Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM) and are useful tools in the process of medical and dental decisions as well as in developing of quality criteria for decision making in many fields of health care. However, there aren’t many studies on SDM and AP in the field of dentistry. This study aimed at exploring patients’ autonomy preferences in dentistry in comparison to other medical domains. Methods: As a first step, a consecutive sample of 100 dental patients and 16 dentists was recruited at a university-based prosthodontic clinic to assess and compare patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions using the Control Preference Scale (CPS). This was followed by a cross sectional survey to study autonomy preferences in three cohorts of 100 patients each recruited from general practices, a multiple sclerosis clinic, and a university-based prosthodontic clinic . A questionnaire with combined items from the Autonomy Preference Index (API) to assess general and the CPS to assess specific preferences was used in this process. Results: Dentists were slightly less willing to deliver control than patients willing to enact autonomy. Decisions about management of tooth loss were however considered relevant for a shared decision making by both parties. Highest AP was expressed by people with multiple sclerosis, lowest by patients in dentistry (CPS means: dentistry 2.5, multiple sclerosis 2.1, general practice 2.4, p=.035). Patients analysis showed considerable differences in autonomy preferences referring to different decision types (p<.001). More autonomy was needed for treatment decisions in comparison to diagnostic decisions, for trivial compared to severe conditions, and for dental care compared to general practice (all: p<.001). Conclusion: The study results showed substantial relevance of patient participation in decision making in dentistry. Furthermore, a need has been discovered to refer to specific medical decisions instead of assessing autonomy preferences in general.

scholarly journals Psychosocial Factors of Dietitians' Intentions to Adopt Shared Decision Making Behaviours: A Cross-Sectional Survey

PLoS ONE ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. e64523 ◽  
Author(s):  
Sarah-Maude Deschênes ◽  
Marie-Pierre Gagnon ◽  
France Légaré ◽  
Annie Lapointe ◽  
Stéphane Turcotte ◽  
...  
Keyword(s):  
Decision Making ◽  
Psychosocial Factors ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Patient autonomy in dental medical decision making – is there a need for shared decision making?

2019 ◽  
Author(s):  
Mareike Benecke ◽  
Jürgen Kasper ◽  
Christoph Heesen ◽  
Nina Schäffler ◽  
Daniel Reissmann
Keyword(s):  
Multiple Sclerosis ◽  
Decision Making ◽  
General Practice ◽  
Shared Decision Making ◽  
Treatment Decisions ◽  
Medical Decision ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Study Results

Abstract Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM) and are useful tools in the process of medical and dental decisions as well as in developing of quality criteria for decision making in many fields of health care. However, there aren’t many studies on SDM and AP in the field of dentistry. This study aimed at exploring patients’ autonomy preferences in dentistry in comparison to other medical domains. Methods: As a first step, a consecutive sample of 100 dental patients and 16 dentists was recruited at a university-based prosthodontic clinic to assess and compare patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions using the Control Preference Scale (CPS). This was followed by a cross sectional survey to study autonomy preferences in three cohorts of 100 patients each recruited from general practices, a multiple sclerosis clinic, and a university-based prosthodontic clinic. A questionnaire with combined items from the Autonomy Preference Index (API) to assess general and the CPS to assess specific preferences was used in this process. Results: Dentists were slightly less willing to deliver control than patients willing to enact autonomy. Decisions about management of tooth loss were however considered relevant for a shared decision making by both parties. Highest AP was expressed by people with multiple sclerosis, lowest by patients in dentistry (CPS means: dentistry 2.5, multiple sclerosis 2.1, general practice 2.4, p=.035). Patients analysis showed considerable differences in autonomy preferences referring to different decision types (p<.001). More autonomy was needed for treatment decisions in comparison to diagnostic decisions, for trivial compared to severe conditions, and for dental care compared to general practice (all: p<.001). Conclusion: The study results showed substantial relevance of patient participation in decision making in dentistry. Furthermore, a need has been discovered to refer to specific medical decisions instead of assessing autonomy preferences in general.

To what extent psychiatric patients feel involved in decision making about their mental health care? Relationships with socio-demographic, clinical, and psychological variables

2013 ◽  
Vol 26 (6) ◽  
pp. 372-381 ◽  
Author(s):  
Carlos De las Cuevas ◽  
Wenceslao Peñate
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Self Efficacy ◽  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Shared Decision ◽  
Psychiatric Outpatients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Relationships

BackgroundShared decision making (SDM) is an essential component of patient-centered care, but there is little information about its use in the psychiatric care.ObjectiveTo measure to what extent psychiatric patients feel they were involved in the process and steps of decision making about treatment choice and to analyse the influence of socio-demographic, clinical, and psychological processes on this perception.MethodsCross-sectional survey involving 1100 consecutive psychiatric outpatients invited to complete the nine-item Shared Decision-Making Questionnaire (SDM-Q-9), health locus of control and control preferences, self-efficacy and drug attitude scales, as well as a questionnaire including socio-demographic and clinical variables.ResultsA high response rate of 77% was registered, resulting in a sample of 846 psychiatric outpatients. SDM-Q-9 total score indicate a moderately low degree of perceived participation, with differing perceived implementation of the individual the SDM process steps. Patient diagnosis evidenced significant differences in SDM perception. Patients’ perception of SDM was explained by four main variables: the older the patient, the lower self-reported SDM; having a diagnosis of schizophrenia increases the likelihood of lower SDM; a positive attitude towards psychiatric drugs favors greater SDM, as well as a higher level of self-efficacy.ConclusionThe result of this study suggests that SDM is currently not widely practiced in psychiatric care. Further research is needed to examine if the low level of participation self-reported is justified by psychiatric patients’ decisional capacity.

scholarly journals Designing a portal to patient-centered care? Let�s start with the patient. A cross-sectional survey. (Preprint)

2017 ◽  
Author(s):  
Steve Alfons Van den Bulck ◽  
Rosella Hermens ◽  
Karin Slegers ◽  
Bert Vandenberghe ◽  
Geert Goderis ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Shared Decision Making ◽  
Information Needs ◽  
Patient Portal ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

BACKGROUND In recent literature, patient portals are considered as important tools for the delivery of patient-centered care. Yet, it is not clear how patients would conceptualize a patient portal and which health information needs they have when doing so. OBJECTIVE 1) To investigate health information needs, expectations and attitudes towards a patient portal. 2) To assess if determinants such as patient characteristics, health literacy and empowerment status can predict two different variables, namely the importance people attribute to obtaining health information when using a patient portal and the expectations concerning personal healthcare when using a patient portal. METHODS A cross-sectional survey was performed in the Flemish population on what patients prefer to know about their digital health data and on their expectations and attitudes towards using a patient portal to access their Electronic Health Record. People were invited to participate in the survey through newsletters, social media and magazines. We used a questionnaire including demographics, health characteristics, health literacy, patient empowerment and patient portal characteristics. RESULTS We received 433 completed surveys. The health information needs included features such as being notified when one’s health changes (93.7%, 371/396), being notified when physical parameters rise to dangerous levels (93.7%, 370/395), to see connections between one’s symptoms/diseases/biological parameters (85.2%, 339/398), to view the evolution of one’s health in function of time (84.5%, 333/394) and to view information about the expected effect of treatment (88.4%, 349/395). Almost 90% (369/412) of respondents were interested in using a patient portal. Determinants of patients’ attachment to obtaining health information on a patient portal were 1) age between 45 and 54 years (P = .047); 2) neutral (P = .030) or interested attitude (P = .008) towards shared decision-making; 3) commitment to question the physicians’ decisions (P = .030). (R2 = .122) Determinants of patients’ expectations on improved healthcare by accessing a patient portal were 1) lower education level (P = .040); 2) neutral (P = .030) or interested attitude (P = .008) towards shared decision-making; 3) problems in understanding health information (P = .037). (R2 = .106) CONCLUSIONS The interest in using a patient portal is considerable in Flanders. People report they would like to receive alerts or some form of communication from a patient portal in case they need to take action to manage their health. Determinants such as education, attached importance to shared decision-making, difficulties in finding relevant health information and the attached importance to questioning the decisions of physicians need to be taken into account in the design of a patient portal.

Knowledge of, and attitudes to, shared decision-making in orthodontics in the UK

2020 ◽  
Vol 47 (4) ◽  
pp. 294-302
Author(s):  
Sophy K Barber ◽  
Fiona Ryan ◽  
Susan J Cunningham
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Orthodontic Treatment ◽  
Online Survey ◽  
Free Text ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Treatment Providers ◽  
The Uk

Objective: To establish UK orthodontic treatment providers’ knowledge of, and attitudes to, shared decision-making (SDM). SDM involves patients as equal partners in decisions about treatment. Design: Cross-sectional survey. Setting: Online survey across the UK. Population: Dentists and orthodontists providing orthodontic treatment in the UK. Methods: Potential participants were contacted through the British Orthodontic Society mailing lists. An online survey was developed to examine knowledge of, and attitudes to, SDM using a combination of evidence-based statements and free text boxes. Questions regarding previous training in SDM and preferences for further training were also included. Results: The survey was completed by 210 respondents, yielding an approximate response rate of 15%. Respondents were mainly consultants (34%) and specialist orthodontists (42%). SDM was well described in terms of the people involved in this process, how it is approached, the components and topics of discussion, and the overall purpose of SDM. Generally, there was consistency in attitudinal responses, with the largest variance in responses to questions about the professional–patient partnership, the interface between SDM and clinical guidelines, and accepting a decision that is discordant with the professional’s opinion. Fifty-one respondents reported having some previous teaching/training in SDM, with the majority (87%) indicating that they would like more training. Conclusion: Clinicians providing orthodontic treatment in the UK have a good understanding of the meaning of shared decision-making. Concerns raised about using SDM and knowledge gaps suggest there is value in providing SDM training for the orthodontic team and that orthodontic providers would welcome it.

Treatment Decision Needs of Psoriasis Patients: Cross-sectional Survey

2010 ◽  
Vol 14 (5) ◽  
pp. 233-239 ◽  
Author(s):  
Jerry Tan ◽  
Dawn Stacey ◽  
Karen Fung ◽  
Benjamin Barankin ◽  
Robert Bissonnette ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Online Survey ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Shared Decision ◽  
Medical Evidence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Values

Background: Informed shared decision making is a mutual process engaging both doctor and patient and informed by best medical evidence and patient values and preferences. Objective: Our aim was to identify the needs of psoriasis patients in decisions on selecting treatment. Methods: Psoriasis subjects participated in an online survey on decisional role, postdecisional conflict, and treatment awareness. Results: Of 2,622 people invited to participate, 248 completed surveys. Their most recent treatment decision was either made by subjects alone (42%) or physicians alone (28%) or was shared (29%). Subjects perceived that their doctors lacked time to stay abreast of treatments, to provide counseling, and to access appropriate treatments. Deficiencies most frequently identified were information on options, clarification of values, access to physicians, and decision-making skills. Those with a body surface area (BSA) ≥ 3% more frequently indicated that having the skill or ability to make treatment decisions was important. Limitations: The limitations of this study include sampling, recall, and reporting bias. Percent BSA was not verified. Conclusions: The multiple deficiencies in support of psoriasis patients in treatment decisions may preclude informed shared decision making.

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