Comparisons of Client and Clinician Views of the Importance of Factors in Client-Clinician Interaction in Hearing Aid Purchase Decisions

2015 ◽  
Vol 26 (03) ◽  
pp. 247-259 ◽  
Author(s):  
Laya Poost-Foroosh ◽  
Mary Beth Jennings ◽  
Margaret F. Cheesman
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Purchase Decisions ◽  
Shared Decision ◽  
Centered Care ◽  
Importance Ratings ◽  
The Mean ◽  
Client Needs

Background: Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology–related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Purpose: Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. Research Design: A cross-sectional approach was used to obtain online and paper-based concept ratings. Data Collection and Analysis: Participants were 43 adults (age range, 45–85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated “the importance of each of the statements in a person’s decision to purchase a hearing aid” on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. Results: There was a significant difference in the mean ratings for clients and clinicians for the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts—understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making—were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. Conclusions: The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients’ perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

Person-centered peritoneal dialysis prescription and the role of shared decision-making

2020 ◽  
Vol 40 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Peter G Blake ◽  
Edwina A Brown
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Shared Decision Making ◽  
Care Delivery ◽  
Shared Decision ◽  
Person Centered Care ◽  
Modern Health Care ◽  
Patient Reported ◽  
Centered Care ◽  
End Stage

Person-centered care has become a dominant paradigm in modern health care. It needs to be applied to people with end-stage kidney disease considering the initiation of dialysis and to peritoneal dialysis (PD) prescription and care delivery. It is relevant to their decisions about goals of care, transplantation, palliative care, and discontinuation of dialysis. It is also relevant to decisions about how PD is delivered, including options such as incremental PD. Shared decision-making is the essence of this process and needs to become a standard principle of care. It requires engagement, education, and empowerment of patients. Patient-reported outcomes and patient-reported experience are also central to person-centered care in PD.

scholarly journals Patient, clinician and independent observer perspectives of shared decision making in adult orthodontics

2021 ◽  
pp. 146531252110075
Author(s):  
Asma Keshtgar ◽  
Susan J Cunningham ◽  
Elinor Jones ◽  
Fiona S Ryan
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Intraclass Correlation ◽  
The Self ◽  
Shared Decision ◽  
Cross Sectional ◽  
Independent Observer ◽  
The Mean ◽  
Patient’S Perception ◽  
Validated Instrument

Objectives: To investigate and compare the extent of shared decision making (SDM) in orthodontics from the perspective of patients, clinicians and independent observers. Design: A cross-sectional, observational study. Setting: NHS teaching hospital. Participants: A total of 31 adult patients and their treating clinicians were included in the study. Methods: The extent of SDM in new patient orthodontic consultations was measured using three versions of a validated instrument: the self-administered patient dyadic-OPTION scale; the self-administered clinician dyadic-OPTION scale; and an independent observer-rated OPTION12 scale. Patients and clinicians completed the 12-item dyadic-OPTION questionnaire independently at the end of the consultation to rate their perceived levels of SDM. The consultations were also audio-recorded and two calibrated raters independently rated the extent of SDM in these consultations using the OPTION12 scale. Results: There was excellent inter-rater reliability between the two independent raters using the OPTION12 scale (intraclass correlation coefficient (ICC) = 0.909). The mean patient, clinician and independent observer OPTION scores for SDM were 90.4% (SD 9.1%, range 70.8% to 100%), 76.2% (SD 8.95%, range 62.5% to 95.8%) and 42.6% (SD 17.4%, range 13.5% to 68.8%), respectively. There was no significant correlation between the OPTION scores for the three groups (ICC = −0.323). Conclusions: The results showed that generally high levels of SDM were perceived by patients and clinicians but lower levels of SDM were scored by the independent observers. However, it could be argued that the patient’s perception of SDM is the most important measure as it is their care that is affected by their involvement.

scholarly journals Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions (Preprint)

2020 ◽  
Author(s):  
Yaara Zisman-Ilani ◽  
Rana Obeidat ◽  
Lauren Fang ◽  
Sarah Hsieh ◽  
Zackary Berger
Keyword(s):  
United States ◽  
Decision Making ◽  
Shared Decision Making ◽  
The United States ◽  
Patient Centered Care ◽  
Survey Study ◽  
Shared Decision ◽  
Patient Centered ◽  
Centered Care ◽  
Comparative Survey

BACKGROUND Shared decision making (SDM) is a health communication model that evolved in Europe and North America and largely reflects the values and medical practices dominant in these areas. OBJECTIVE This study aims to understand the beliefs, perceptions, and practices related to SDM and patient-centered care (PCC) of physicians in Israel, Jordan, and the United States. METHODS A hypothesis-generating comparative survey study was administered to physicians from Israel, Jordan, and the United States. RESULTS A total of 36 surveys were collected via snowball sampling (Jordan: n=15; United States: n=12; Israel: n=9). SDM was perceived as a way to inform patients and allow them to participate in their care. Barriers to implementing SDM varied based on place of origin; physicians in the United States mentioned limited time, physicians in Jordan reported that a lack of patient education limits SDM practices, and physicians in Israel reported lack of communication training. Most US physicians defined PCC as a practice for prioritizing patient preferences, whereas both Jordanian and Israeli physicians defined PCC as a holistic approach to care and to prioritizing patient needs. Barriers to implementing PCC, as seen by US physicians, were mostly centered on limited appointment time and insurance coverage. In Jordan and Israel, staff shortage and a lack of resources in the system were seen as major barriers to PCC implementation. CONCLUSIONS The study adds to the limited, yet important, literature on SDM and PCC in areas of the world outside the United States, Canada, Australia, and Western Europe. The study suggests that perceptions of PCC might widely differ among these regions, whereas concepts of SDM might be shared. Future work should clarify these differences.

scholarly journals Partnerships to Improve Shared Decision Making for Patients with Hypertension: Health Equity Implications

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 97-102
Author(s):  
Aisha T. Langford ◽  
Stephen K. Williams ◽  
Melanie Applegate ◽  
Olugbenga Ogedegbe ◽  
Ronald S. Braithwaite
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Equity ◽  
Clinical Care ◽  
Lifestyle Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Broad Array ◽  
Centered Care

Shared decision making (SDM) has increas­ingly become appreciated as a method to enhance patient involvement in health care decisions, patient-provider communication, and patient-centered care. Compared with cancer, the literature on SDM for hyperten­sion is more limited. This is notable because hypertension is the leading risk factor for cardiovascular disease and both conditions disproportionately affect certain subgroups of patients. However, SDM holds prom­ise for improving health equity by better engaging patients in their health care. For example, many reasonable options exist for treating uncomplicated stage-1 hyperten­sion. These options include medication and/ or lifestyle changes such as healthy eating, physical activity, and weight management. Deciding on “the best” plan of action for hypertension management can be challeng­ing because patients have different goals and preferences for treatment. As hyper­tension management may be considered a preference-sensitive decision, adherence to treatment plans may be greater if those plans are concordant with patient prefer­ences. SDM can be implemented in a broad array of care contexts, from patient-provider dyads to interprofessional collaborations. In this article, we argue that SDM has the potential to advance health equity and improve clinical care. We also propose a process to evaluate whether SDM has occurred and suggest future directions for research.Ethn Dis. 2019;29(Suppl 1):97- 102; doi:10.18865/ed.29.S1.97.

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