scholarly journals Shared Decision Making. Patient Involvement in Clinical Practice: Glyn Elwyn. Nijmegen, The Netherlands: WOK, 2001, pound10.00, pp 221. ISBN 90 76316 12 0

2002 ◽  
Vol 11 (3) ◽  
pp. 297-a-298
Author(s):  
R Say
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
The Netherlands ◽  
Shared Decision Making ◽  
Patient Involvement ◽  
Shared Decision

scholarly journals THU0647-HPR SHARED DECISION MAKING AMONGST RHEUMATOLOGISTS IN TRAINING IN THE NETHERLANDS: WHERE DO WE STAND?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 568.2-568
Author(s):  
L. Kranenburg ◽  
M. Dankbaar ◽  
N. Basoski ◽  
W. Van den Broek ◽  
J. Hazes
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Shared Decision Making ◽  
Online Survey ◽  
Daily Practice ◽  
Clear Understanding ◽  
Shared Decision ◽  
Professional Activities ◽  
Self Evaluation ◽  
The Subject

Background:The training curriculum for rheumatologists in training in the Netherlands describes competences and entrusted professional activities (EPA) to monitor the progress in learning. However, this training program does not discuss training of Shared Decision Making. As the basis for shared care and patient participation is made during these years, the question arises how rheumatologist in training think about Shared Decision Making and how they use this in daily practice.Objectives:Inventory of vision, experience and self-evaluation of skills related to Shared Decision Making amongst rheumatologists in training in the Netherlands in order to identify barriers in the implementation of Shared Decision Making in daily practice.Methods:Qualitative data was collected from on online survey amongst rheumatologists in training who were registered in January 2018 by the Dutch Society of Rheumatology.Results:Forty-two rheumatologists in training from various years of training responded (60%). Respondents think that Shared Decision Making is important. A third applies Shared Decision Making on a regular basis in daily practice. Self rating of skills for Shared Decision Making varies from sufficient to good. However, respondents are uncertain about their performance due to a lack of feedback and unclearness of the concept. They indicate that Shared Decision Making is not possible for all patients and find it difficult to assess whether the patient has a clear understanding of the options. Patient’s preferences are discussed only by 33% of the doctors on a regular basis when starting new treatment.Conclusion:Rheumatologists in training agree on the importance of Shared Decision Making, but are uncertain about their performance. Unclearness of the concept is described as a known barrier in literature1,2and is frequently mentioned by respondents. Rheumatologist in training indicate that not all patients are fit for Shared Decision Making. Regarding the limited training on the subject this could also be a misjudgment of patients preferences and lack of experience how to deal with different patient types. There is a clear plea for more training and feedback on the subject. Training should be integrated in the curriculum focusing on how to assess patients preferences and how to apply Shared Decision Making also for patients who indicate to leave decisions up to their doctor.References:[1]van Veenendaal, H.et al.Accelerating implementation of shared decision-making in the Netherlands: An exploratory investigation.Patient Educ Couns101, 2097-2104 (2018).[2]Legare, F., Ratte, S., Gravel, K. & Graham, I. D. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions.Patient Educ Couns73, 526-535 (2008).Disclosure of Interests:Laura Kranenburg Grant/research support from: Pfizer and UCB for the development of the Reuma App, a tool to support selfmanagement for patients. This is not used for the research related to the submitted abstract., Mary Dankbaar: None declared, Natalja Basoski: None declared, Walter Van den Broek: None declared, Johanna Hazes: None declared

Patient Involvement in Anesthesia Decision-making: A Qualitative Study of Knee Arthroplasty

2021 ◽  
Author(s):  
Veena Graff ◽  
Justin T. Clapp ◽  
Sarah J. Heins ◽  
Jamison J. Chung ◽  
Madhavi Muralidharan ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Shared Decision ◽  
Structured Interviews ◽  
Primary Knee Arthroplasty

Background Calls to better involve patients in decisions about anesthesia—e.g., through shared decision-making—are intensifying. However, several features of anesthesia consultation make it unclear how patients should participate in decisions. Evaluating the feasibility and desirability of carrying out shared decision-making in anesthesia requires better understanding of preoperative conversations. The objective of this qualitative study was to characterize how preoperative consultations for primary knee arthroplasty arrived at decisions about primary anesthesia. Methods This focused ethnography was performed at a U.S. academic medical center. The authors audio-recorded consultations of 36 primary knee arthroplasty patients with eight anesthesiologists. Patients and anesthesiologists also participated in semi-structured interviews. Consultation and interview transcripts were coded in an iterative process to develop an explanation of how anesthesiologists and patients made decisions about primary anesthesia. Results The authors found variation across accounts of anesthesiologists and patients as to whether the consultation was a collaborative decision-making scenario or simply meant to inform patients. Consultations displayed a number of decision-making patterns, from the anesthesiologist not disclosing options to the anesthesiologist strictly adhering to a position of equipoise; however, most consultations fell between these poles, with the anesthesiologist presenting options, recommending one, and persuading hesitant patients to accept it. Anesthesiologists made patients feel more comfortable with their proposed approach through extensive comparisons to more familiar experiences. Conclusions Anesthesia consultations are multifaceted encounters that serve several functions. In some cases, the involvement of patients in determining the anesthetic approach might not be the most important of these functions. Broad consideration should be given to both the applicability and feasibility of shared decision-making in anesthesia consultation. The potential benefits of interventions designed to enhance patient involvement in decision-making should be weighed against their potential to pull anesthesiologists’ attention away from important humanistic aspects of communication such as decreasing patients’ anxiety. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Usability and Perceived Usefulness of the AFib 2gether™ Mobile App in a Clinical Setting: Single-Arm Intervention Study (Preprint)

2021 ◽  
Author(s):  
Alok Kapoor ◽  
Anna Hayes ◽  
Jay Patel ◽  
Harshal Patel ◽  
Andreza Andrade ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Involvement ◽  
Rating Scale ◽  
Mobile App ◽  
Perceived Usefulness ◽  
Controlled Study ◽  
Average Score ◽  
Shared Decision ◽  
Item Questionnaire

BACKGROUND Although the American Heart Association and other professional societies have recommended shared decision-making as a way for patients with atrial fibrillation or flutter (AF) to reach informed decisions about using anticoagulation (AC), the best method of facilitating shared decision-making remains uncertain. OBJECTIVE The aim of this study is to assess the AFib 2gether™ mobile app for usability, perceived usefulness, and extent and nature of shared decision making that occurred for clinical encounters between patients with AF and their cardiology providers in which the app was used. METHODS We identified patients coming to see a cardiology provider from October 2019 until May 2020. We measured usability from patients and providers through the mobile app rating scale (MARS). From the eight items of the MARS, we report the average score (out of 5) for domains of functionality, aesthetics, and overall quality. We administered a three-item questionnaire to patients relating to their perceived usefulness and a separate three-item questionnaire to providers to measure their perceived usefulness. We performed a chart review to track AC starts occurring within 6 months of the index visit. We also audio-recorded a subset of encounters to identify evidence of shared decision-making. RESULTS We facilitated shared decision-making visits for 37 patients seeing 13 providers. In terms of usability, patients’ ratings of functionality, aesthetics, and overall quality were (average ± standard deviation): 4.51 ± 0.61, 4.26 ± 0.51, and 4.24 ± 0.89, respectively. In terms of usefulness, 40% of patients agreed that the app improved their knowledge regarding AC and 62% agreed that the app helped clarify to their provider, their preferences regarding AC. Among providers, 79% agreed that the app helped clarify their patients’ preferences; 82% agreed that the app saved them time; and 59% agreed that the app helped their patients make decisions about AC. Additionally, 12 patients started AC after their shared decision-making visits. We audio-recorded 25 encounters. Of these encounters, 84% included mention of AC for AF, 44% included discussion of multiple options for AC, 72% included a provider recommendation for AC, and 48% included evidence of patient involvement in the discussion. CONCLUSIONS Patients and providers rated the app with high usability and perceived usefulness. Moreover, a third of patients began AC and in nearly ½ the encounters, there was evidence of patient involvement in decision-making. In the future, we plan to study the effect of the app in a larger sample and with a controlled study design. CLINICALTRIAL ClinicalTrials.gov NCT04118270. INTERNATIONAL REGISTERED REPORT RR2-21986

scholarly journals A descriptive model of shared decision making derived from routine implementation in clinical practice (‘Implement-SDM’): Qualitative study

2019 ◽  
Vol 102 (10) ◽  
pp. 1774-1785 ◽  
Author(s):  
Natalie Joseph-Williams ◽  
Denitza Williams ◽  
Fiona Wood ◽  
Amy Lloyd ◽  
Katherine Brain ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Descriptive Model

scholarly journals Process and impact of patient involvement in a systematic review of shared decision making in primary care consultations

2016 ◽  
Vol 20 (2) ◽  
pp. 298-308 ◽  
Author(s):  
Catherine Hyde ◽  
Kate M. Dunn ◽  
Adele Higginbottom ◽  
Carolyn A. Chew-Graham
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Patient Involvement ◽  
Shared Decision

scholarly journals Learning shared decision-making in clinical practice

2020 ◽  
Author(s):  
Anke J.M. Oerlemans ◽  
Marjan L. Knippenberg ◽  
Gert J. Olthuis
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Shared Decision Making ◽  
Shared Decision

Patient involvement in consultation for atrial fibrillation – the cardiologists’ perspective

2019 ◽  
Vol 32 (4) ◽  
pp. 765-776 ◽  
Author(s):  
Ulla Hellström Muhli ◽  
Jan Trost ◽  
Eleni Siouta
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Content Analysis ◽  
Shared Decision Making ◽  
Patient Involvement ◽  
Qualitative Content Analysis ◽  
Medical Consultation ◽  
Shared Decision ◽  
Consultation Process ◽  
Content Type

Purpose The purpose of this paper is to analyse the accounts of Swedish cardiologists concerning patient involvement in consultations for atrial fibrillation (AF). The questions were: how cardiologists handle and provide scope for patient involvement in medical consultations regarding AF treatment and how cardiologists describe their familiarity with shared decision-making. Design/methodology/approach A descriptive study was designed. Ten interviews with cardiologists at four Swedish hospitals were held, and a qualitative content analysis was performed on the collected data. Findings The analysis shows cardiologists’ accounts of persuasive practice, protective practice, professional role and medical craftsmanship when it comes to patient involvement and shared decision-making. The term “shared decision-making” implies a concept of not only making one decision but also ensuring that it is finalised with a satisfactory agreement between both parties involved, the patient as well as the cardiologist. In order for the idea of patient involvement to be fulfilled, the two parties involved must have equal power, which can never actually be guaranteed. Research limitations/implications Methodologically, this paper reflects the special contribution that can be made by the research design of descriptive qualitative content analysis (Krippendorff, 2004) to reveal and understand cardiologists’ perspectives on patient involvement and participation in medical consultation and shared decision-making. The utility of this kind of analysis is to find what cardiologists said and how they arrived at their understanding about patient involvement. Accordingly, there is no quantification in this type of research. Practical implications Cardiologists should prioritise patient involvement and participation in decision-making regarding AF treatment decisions in consultations when trying to meet the request of patient involvement. Originality/value Theoretically, the authors have learned that the patient involvement and shared decision-making requires the ability to see patients as active participants in the medical consultation process.

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