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.

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 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 Exploring healthcare professionals’ knowledge, attitudes and experiences of shared decision making in rheumatology

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001121
Author(s):  
Elke G E Mathijssen ◽  
Bart J F van den Bemt ◽  
Sabien Wielsma ◽  
Frank H J van den Hoogen ◽  
Johanna E Vriezekolk
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Shared Decision Making ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Active Role ◽  
Barriers And Facilitators ◽  
Shared Decision ◽  
Cross Sectional ◽  
Exact Test

ObjectivesTo explore physicians’ and nurses’ knowledge, attitudes and experiences of shared decision making (SDM) in rheumatology, to identify barriers and facilitators to SDM, and to examine whether physicians’ and nurses’ perspectives of SDM differ.MethodsA cross-sectional, exploratory, online survey was used. Besides demographic characteristics, healthcare professionals’ knowledge, attitudes and experiences of SDM in rheumatology were assessed. Barriers and facilitators to SDM were identified from healthcare professionals’ answers. Descriptive statistics were computed and differences between physicians’ and nurses’ perspectives of SDM were examined with a t-test or Fisher’s exact test, as appropriate.ResultsBetween April and June 2019, 77 physicians and 70 nurses completed the survey. Although most healthcare professionals lacked a full conceptual understanding of SDM, almost all physicians (92%) and all nurses had a (very) positive attitude toward SDM, which was most frequently motivated by the belief that SDM improves patients’ treatment adherence. The majority (>50%) of healthcare professionals experienced problems with the application of SDM in clinical practice, mostly related to time constraints. Other important barriers were the incompatibility of SDM with clinical practice guidelines and beliefs that patients do not prefer to be involved in decision making or are not able to take an active role. Modest differences between physicians’ and nurses’ perspectives of SDM were found.ConclusionsThere is a clear need for education and training that equips and empowers healthcare professionals to apply SDM. Furthermore, the commitment of time, resources and financial support for national, regional and organisational initiatives is needed to make SDM in rheumatology a practical reality.

Attitudes, Beliefs, and Practices of Aesthetic Plastic Surgeons Regarding Informed Consent

2019 ◽  
Author(s):  
Chelsea O Hagopian ◽  
Teresa B Ades ◽  
Thomas M Hagopian ◽  
Erik M Wolfswinkel ◽  
W Grant Stevens
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Plastic Surgery ◽  
Shared Decision Making ◽  
Online Survey ◽  
Free Text ◽  
Shared Decision ◽  
Essential Information ◽  
Beliefs And Practices ◽  
Aesthetic Plastic Surgery

Abstract Background Best practice for informed consent in aesthetic plastic surgery is a process of shared decision-making, yet evidence strongly suggests this is not commonly reflected in practice nor is it supported by traditional informed consent documents (ICD). Falsely held beliefs by clinicians about shared decision-making may contribute to its lack of adoption. Objective The authors sought to understand the baseline attitudes, beliefs, and practices of informed consent among board-certified plastic surgeons with a primarily aesthetics practice. Methods A 15-question online survey was emailed to active members of the American Society for Aesthetic Plastic Surgery. Items included demographics, Likert scales, free-text, acceptability, and 1 question seeking consensus on general information all patients must understand before any surgery. Results This survey yielded a 13% response rate with a 52% completion rate across 10 countries and 31 US states. A total of 69% were very or extremely confident that ICD contain evidence-based information, but 63% were not at all or not so confident in ICD effectiveness of prompting patients to teach-back essential information. A total of 50% believed surgical ICD should be reviewed annually. Eighty-six percent reported assistance with patient education during informed consent. Members of professional plastic surgery societies should be a source of evidence for content (free-text). A total of 64% were somewhat to very satisfied with the survey and 84% will probably to definitely participate in future related surveys. Conclusions The findings echo concerns in the literature that ICD are focused on disclosure instead of patient understanding. There is notable concern regarding information overload and retention but less regarding the quality and completeness of information. Current culture suggests key clinician stakeholders are amenable to change.

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 Medical Students’ Knowledge and Attitudes Toward Shared Decision Making: Results From a Multinational, Cross-Sectional Survey

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831988587
Author(s):  
Renata W. Yen ◽  
Paul J. Barr ◽  
Nan Cochran ◽  
Johanna W. Aarts ◽  
France Légaré ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Risk Communication ◽  
Shared Decision Making ◽  
Online Survey ◽  
Medical Schools ◽  
The United States ◽  
Shared Decision ◽  
Cross Sectional ◽  
Convenience Sample

Introduction. We aimed to conduct a multinational cross-sectional online survey of medical students’ attitudes toward, knowledge of, and experience with shared decision making (SDM). Methods. We conducted the survey from September 2016 until May 2017 using the following: 1) a convenience sample of students from four medical schools each in Canada, the United States, and the Netherlands ( n = 12), and 2) all medical schools in the United Kingdom through the British Medical School Council ( n = 32). We also distributed the survey through social media. Results. A total of 765 students read the information sheet and 619 completed the survey. Average age was 24, 69% were female. Mean SDM knowledge score was 83.6% (range = 18.8% to 100%; 95% confidence interval [CI] = 82.8% to 84.5%). US students had the highest knowledge scores (86.2%, 95% CI = 84.8% to 87.6%). The mean risk communication score was 57.4% (range = 0% to 100%; 95% CI = 57.4% to 60.1%). Knowledge did not vary with age, race, gender, school, or school year. Attitudes were positive, except 46% believed SDM could only be done with higher educated patients, and 80.9% disagreed that physician payment should be linked to SDM performance (increased with years in training, P < 0.05). Attitudes did not vary due to any tested variable. Students indicated they were more likely than experienced clinicians to practice SDM (72.1% v. 48.8%). A total of 74.7% reported prior SDM training and 82.8% were interested in learning more about SDM. Discussion. SDM knowledge is high among medical students in all four countries. Risk communication is less well understood. Attitudes indicate that further research is needed to understand how medical schools deliver and integrate SDM training into existing curricula.

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