scholarly journals Adapting the patient and physician versions of the 9-item shared decision making questionnaire for other healthcare providers in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuko Goto ◽  
Yasuhiro Yamaguchi ◽  
Joji Onishi ◽  
Hidenori Arai ◽  
Martin Härter ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Secondary Analysis ◽  
Reliability And Validity ◽  
Multidisciplinary Teams ◽  
The Novel ◽  
Shared Decision ◽  
Care Providers ◽  
Term Care ◽  
Training Setting

Abstract Background In Japan, the number of older people with various health problems and difficulties in living is increasing. In order to practice patient-centered care for them, not only medical professionals but also multidisciplinary teams including care professionals and patients need to practice shared decision making (SDM) in the context of long-term care. For this reason, a measure of SDM in consultations with healthcare professionals (HCPs) other than physicians is needed. Therefore, this study aimed at adapting the patient and physician versions of the 9-item Shared Decision Making Questionnaire (SDM-Q-9, SDM-Q-Doc) for consultations with HCPs other than physicians in Japan. Methods A pair of SDM measures that can be used by HCPs other than physicians, “Care SDM-Questionnaire for care receivers (SDM-C-patient)” and “Care SDM-Questionnaire for care providers (SDM-C-provider)” were prepared based on the Japanese versions of the SDM-Q-9 and SDM-Q-Doc. The internal consistency and conceptual structure of these measures were tested by secondary analysis of data from 496 participants from a workshop on SDM for different HCPs. Measurement invariance were tested by multigroup confirmatory factor analysis (CFA) for the patient (SDM-C-patient and SDM-Q-9) and provider (SDM-C-provider vs. SDM-Q-Doc) versions. Results Both the Japanese SDM-C-patient and SDM-C-provider demonstrated high internal consistencies (Cronbach’s α coefficient was 0.90 and McDonald’s ω coefficient was 0.90 for both measures). CFA showed one-factor structures for both measures and original measures for physicians. Moreover, multigroup CFA showed configural and metric invariance between the novel care measures and original physician’s measures. Conclusions Thus, the novel SDM measures for care providers in Japan as well as the original physician’s measures could be used in training setting. As these measures were tested only in a training setting, their reliability and validity as new measures for care should be tested in a clinical setting in future.

scholarly journals The Multifocal Approach to Sharing in Shared Decision Making: A Critical Appraisal of the MAPPIN’SDM

2021 ◽  
pp. 0272989X2110107
Author(s):  
David Forner ◽  
Christopher W. Noel ◽  
Laura Boland ◽  
Arwen H. Pieterse ◽  
Cornelia M. Borkhoff ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Critical Appraisal ◽  
Reliability And Validity ◽  
Measurement Instrument ◽  
Face Validity ◽  
Shared Decision ◽  
Measurement Instruments ◽  
Multiple Perspectives ◽  
Property Assessment

Objective Shared decision making integrates health care provider expertise with patient values and preferences. The MAPPIN’SDM is a recently developed measurement instrument that incorporates physician, patient, and observer perspectives during medical consultations. This review sought to critically appraise the development, sensibility, reliability, and validity of the MAPPIN’SDM and to determine in which settings it has been used. Methods This critical appraisal was performed through a targeted review of the literature. Articles outlining the development or measurement property assessment of the MAPPIN’SDM or that used the instrument for predictor or outcome purposes were identified. Results Thirteen studies were included. The MAPPIN’SDM was developed by both adapting and building on previous shared decision making measurement instruments, as well as through creation of novel items. Content validity, face validity, and item quality of the MAPPIN’SDM are adequate. Internal consistency ranged from 0.91 to 0.94 and agreement statistics from 0.41 to 0.92. The MAPPIN’SDM has been evaluated in several populations and settings, ranging from chronic disease to acute oncological settings. Limitations include high reading levels required for self-administered patient questionnaires and the small number of studies that have employed the instrument to date. Conclusion The MAPPIN’SDM generally shows adequate development, sensibility, reliability, and validity in preliminary testing and holds promise for shared decision making research integrating multiple perspectives. Further research is needed to develop its use in other patient populations and to assess patient understanding of complex item wording.

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.

scholarly journals Multidisciplinary teams caring for people with variations of sex characteristics: a scoping review

2021 ◽  
Vol 5 (1) ◽  
pp. e001257
Author(s):  
Martin Gramc ◽  
Jürg Streuli ◽  
Eva de Clercq
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Scoping Review ◽  
Ethical Principles ◽  
Care Process ◽  
Future Research ◽  
Medical Professionals ◽  
Sex Characteristics ◽  
Multidisciplinary Teams ◽  
Shared Decision

BackgroundIn 2006 the Chicago consensus statement on the management of people with variations of sex characteristics (VSC) acknowledged the importance of a multidisciplinary team (MDT) approach. The consensus update from 2016 reinforced the call for multidisciplinary collaborations between medical professionals, parents and support groups, and proposed guidelines to improve shared decision making and patient-centred care embedded in ethical principles of self-determination and child participation. But there is little evidence that successfully MDTs have been implemented in clinical practice.Methods and aimsA scoping review was conducted to identify studies that address the collaboration and decision making process of MDTs providing care of people with VSC to identify ideal and actual (1) team composition; (2) models of collaboration and (3) ethical principles that MDTs follow. Six databases were systematically searched: CINAHIL, Medline, Psychinfo, Scopus, Socindex and Web of Science. No restriction was placed on the type of methodology used in the studies. To frame the research, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used.ResultsThe MDTs in the literature include mainly medical professionals: endocrinologists, urologists and surgeons. The collaboration among medical professionals in MDTs lacks cooperation as one team member sets the tasks of the team while each professional works separately. Despite the importance of psycho-social support the involvement of psychologists remains secondary. The implementation of ethical principles tends to exclude people with VSC.ConclusionThe care of people with VSC described in the papers is medically oriented as the team members are mainly medical professionals working separately. MDT tend to exclude people with VSC despite references to shared decision making processes and informed consent. There was no mention of adult care and lack of inclusion of patient’s perspective in the care process. The future research should do more empirical research of MDTs.

scholarly journals An integrated knowledge translation approach to develop a shared decision-making strategy for use by Inuit in cancer care: a qualitative study

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
J. Jull ◽  
A. Hizaka ◽  
A. J. Sheppard ◽  
A. Kewayosh ◽  
P. Doering ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Knowledge Translation ◽  
Shared Decision Making ◽  
Cancer Care ◽  
Community Support ◽  
Integrated Knowledge Translation ◽  
Shared Decision ◽  
Care Providers ◽  
Integrated Knowledge

Background In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use. In shared decision-making (sdm), health care providers and patients make health care decisions together. Enhanced participation in cancer care decisions is a need for Inuit. Integrated knowledge translation (kt) supports the development of research evidence that is likely to be patient-centred and applied in practice.Objective Using an integrated kt approach, we set out to promote the use of sdm by Inuit in cancer care.Methods An integrated kt study involving researchers with a Steering Committee of cancer care system partners who support Inuit in cancer care (“the team”) consisted of 2 theory-driven phases:■ using consensus-building methods to tailor a previously developed sdm strategy and developing training in the sdm strategy; and■ training community support workers (csws) in the sdm strategy and testing the sdm strategy with community members.Results The team developed a sdm strategy that included a workshop and a booklet with 6 questions for use by csws with patients. The sdm strategy (training and booklet) was finalized based on feedback from 5 urban-based Inuit csws who were recruited and trained in using the strategy. Trained csws were matched with 8 community members, and use of the sdm strategy was assessed during interviews, reported as 6 themes. Participants found the sdm strategy to be useful and feasible for use.Conclusions An integrated kt approach of structured research processes with partners developed a sdm strategy for use by Inuit in cancer care. Further work is needed to test the sdm strategy.

The Impact of a Shared Decision-Making Training Program on Dementia Care Planning in Long-Term Care

2018 ◽  
Vol 64 (4) ◽  
pp. 1123-1135 ◽  
Author(s):  
Elena Mariani ◽  
Rabih Chattat ◽  
Giovanni Ottoboni ◽  
Raymond Koopmans ◽  
Myrra Vernooij-Dassen ◽  
...  
Keyword(s):  
Decision Making ◽  
Training Program ◽  
Shared Decision Making ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Planning ◽  
Shared Decision ◽  
Term Care ◽  
The Impact

scholarly journals The impact of DECISION+2 on patient intention to engage in shared decision making: secondary analysis of a multicentre clustered randomized trial

2014 ◽  
Vol 18 (6) ◽  
pp. 2629-2637 ◽  
Author(s):  
Nicolas Couët ◽  
Michel Labrecque ◽  
Hubert Robitaille ◽  
Stéphane Turcotte ◽  
France Légaré
Keyword(s):  
Decision Making ◽  
Randomized Trial ◽  
Shared Decision Making ◽  
Secondary Analysis ◽  
Shared Decision ◽  
The Impact

scholarly journals Shared decision-making in food allergy management

2020 ◽  
Vol 2 (1) ◽  
pp. 124-127
Author(s):  
Meera Patrawala ◽  
Gerald Lee ◽  
Brian Vickery
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Food Allergy ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Decision Aids ◽  
Shared Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Evidenced Based

Historically, the role of the health-care provider in medical practice has been primarily paternalistic by offering information, compassion, and decisive views with regard to medical decisions. This approach would exclude patients in the decision-making process. In a shift toward more patient-centered care, health-care providers are routinely encouraged to practice shared decision making (SDM). SDM uses evidence-based information about the options, elicitation of patient preferences, and decision support based on the patient’s needs with the use of decision aids or counseling. Although there are well-known benefits of SDM, including improvements in psychological, clinical, and health-care system domains providers have found it challenging to apply SDM in everyday clinical practice. In allergy, we have a unique role in the treatment of children and adults, and SDM should be applied appropriately when engaging with these specific groups. There are many situations in which there is not a clear best option (food allergy testing, food introduction and challenges, and immunotherapy). Therefore, decision aids specific to our field, coupled with evidenced-based information that ultimately leads to a decision that reflects the patient’s values will make for a vital skill in practice. In this article, we defined SDM, the benefits and barriers to SDM, unique situations in SDM, and approach to SDM in food allergy.

scholarly journals Validation of the SDM Process Scale to Evaluate Shared Decision-Making at Clinical Sites

2021 ◽  
Vol 8 ◽  
pp. 237437352110608
Author(s):  
Floyd J. Fowler ◽  
Karen R. Sepucha ◽  
Vickie Stringfellow ◽  
KD Valentine
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Reliability And Validity ◽  
Breast Cancer Surgery ◽  
Shared Decision ◽  
Average Correlation ◽  
Intra Class Correlation ◽  
Mail Surveys ◽  
Process Scale

The Shared Decision-Making (SDM) Process scale (scored 0-4) uses 4 questions about decision-making behaviors: discussion of options, pros, cons, and preferences. We use data from mail surveys of patients who made surgical decisions at 9 clinical sites and a national web survey to assess the reliability and validity of the measure to assess shared decision-making at clinical sites. Patients at sites using decision aids to promote shared decision-making for hip, knee, back, or breast cancer surgery had significantly higher scores than national cross-section samples of surgical patients for 3 of 4 comparisons and significantly higher scores for both comparisons with “usual care sites.” Reliability was supported by an intra-class correlation at the clinical site level of 0.93 and an average correlation of SDM scores for knee and hip surgery patients treated at the same sites of 0.56. The results document the reliability and validity of the measure to assess the degree of shared decision-making for surgical decisions at clinical sites.

scholarly journals A Systematic Literature Review of Shared Decision Making in Cancer Care (Preprint)

2018 ◽  
Author(s):  
Colleen A. McHorney ◽  
Lindsey T. Murray ◽  
Dayo Jagun ◽  
Jennifer Whiteley ◽  
Miriam Kimel ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Quality Of Care ◽  
Shared Decision Making ◽  
Cancer Care ◽  
Quantitative Measure ◽  
Shared Decision ◽  
Care Providers ◽  
Clinician Communication

BACKGROUND Shared decision making (SDM) is a process in which health care providers and patients relate to and influence each other as they collaborate in making decisions about patients’ health care. Hypothesized as a means to improve quality of care, successful applications of SDM in routine cancer care have not been widely documented. OBJECTIVE The objective of this study was to examine the literature to determine if elements of SDM implementation between cancer patients and their clinicians were more or less successful at improving the quality of care and health outcomes. METHODS A systematic literature search of SDM approaches and outcomes in cancer care was conducted using PubMed and EMBASE. An integrative model for SDM was used to classify elements included in SDM intervention studies and the resulting outcomes. RESULTS From 1,018 unique publications, 23 articles meeting eligibility criteria were included. Only three studies addressed elements of patient-clinician interaction as part of the study objectives. Interventions included decision aid (DA) evaluation (n=22) and clinician communication training (n=1). SDM elements commonly included were: defining/explaining the problem (n=23); presenting options (n=19); discussing pros and cons (n=17); assessing patient priorities and preferences (n=17); clinician knowledge and recommendations (n=15); and making or deferring treatment decisions (n=12). The most frequently-measured outcomes were patient-reported outcomes including treatment preference or decision (n=12), decisional conflict (n=10), patient satisfaction (n=10), patient participation (n=9), and patient knowledge (n=7). No clear patterns demonstrating relationships between SDM elements and outcomes were identified. Information on how patients and clinicians utilized DA information to promote SDM was limited. CONCLUSIONS Evaluation of SDM in cancer care has been increasing. However, the term “SDM” was generally applied to studies that focused on the development and/or evaluation of DAs which limited the current analyses to a review of SDM elements as part of the DAs. Most studies did not include a qualitative or quantitative measure of SDM specific to patient-clinician communication and interaction. Instead, there was an underlying assumption that SDM occurred organically with DA implementation. Without a qualitative or quantitative measure of SDM, identification of successful SDM elements and their relationships to patient outcomes remains unclear. Additional research is warranted on SDM implementation and measurement in real-world cancer care settings.

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