Exploring Shared Decision Making Between Family Caregivers, Persons With Disorders of Consciousness, and Rehabilitation Therapists in Acute Care

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This qualitative, observational research study explored treatment encounters between patients with disorders of consciousness, rehabilitation practitioners, and family to understand how treatment decisions occurred. The data showed shared decision making (SDM) occurring as a process, meaning that not all five principles of SDM occur in one clinical encounter but rather unfold across multiple clinical encounters. We delineate differences in SDM between rehabilitation and the medical model. Primary Author and Speaker: Jennifer Weaver Contributing Authors: Trudy Mallinson, Leslie Davidson, Christina Papadimitriou, Ann Guernon, and Philip van der Wees

Download Full-text

Observer Ratings of Shared Decision Making Do Not Match Patient Reports: An Observational Study in 5 Family Medicine Practices

Medical Decision Making ◽

10.1177/0272989x20977885 ◽

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.

Download Full-text

SHARED DECISION MAKING IN DEMENTIA CARE PLANNING: INVOLVING FAMILY CAREGIVERS

Innovation in Aging ◽

10.1093/geroni/igx004.2369 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 667-667

Author(s):

M. Vernooij-Dassen ◽

E. Mariani ◽

Y. Engels ◽

R. Chattat

Keyword(s):

Decision Making ◽

Family Caregivers ◽

Shared Decision Making ◽

Dementia Care ◽

Care Planning ◽

Shared Decision

Download Full-text

Self-management strategies in neurorehabilitation

Oxford Textbook of Neurorehabilitation ◽

10.1093/med/9780198824954.003.0028 ◽

2020 ◽

pp. 387-400

Author(s):

Fiona Jones ◽

Sara Demain

Keyword(s):

Decision Making ◽

Chronic Disease ◽

Healthcare Professional ◽

Shared Decision Making ◽

Management Strategies ◽

Self Management ◽

Shared Decision ◽

Collaborative Approach ◽

Clinical Encounters ◽

Measuring Outcomes

This chapter examines self-management in a way that introduces evidence, ideas, and concepts which illustrate the benefits of a personalized collaborative approach to neurorehabilitation. It reviews constructions of self-management from the chronic disease literature and the relevance to neurology and overlapping methods such as shared decision-making, health coaching, and motivational interviewing. It also reviews the benefits of integrating key self-management strategies into clinical encounters and current methods of measuring outcomes. It has been written for any healthcare professional who seeks to understand how to support and enable self-management within neurorehabilitation.

Download Full-text

Shared decision‐making in tinnitus care – An exploration of clinical encounters

British Journal of Health Psychology ◽

10.1111/bjhp.12308 ◽

2018 ◽

Vol 23 (3) ◽

pp. 630-645 ◽

Cited By ~ 6

Author(s):

Helen Pryce ◽

Amanda Hall ◽

Elizabeth Marks ◽

Beth‐Anne Culhane ◽

Sarah Swift ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Shared Decision ◽

Clinical Encounters

Download Full-text

Shared decision-making, decision aids, and the role of values in treatment decision-making

10.1093/med/9780198736134.003.0004 ◽

2017 ◽

Author(s):

Amiram Gafni ◽

Cathy Charles

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Conceptual Development ◽

Decision Aids ◽

Treatment Decision ◽

Clinical Encounter ◽

Shared Decision ◽

Treatment Decision Making ◽

Key Characteristics

Shared decision-making (SDM) between physicians and patients is often advocated as the ‘best’ approach to treatment decision-making in the clinical encounter. In this chapter we describe: (i) the key characteristics of a SDM approach; (ii) the clinical contexts for SDM; (iii) the definition and use of decision aids (DA), as well as their relationship to SDM; and (iv) the vexing problem of defining the meaning and role of values/preferences in treatment decision-making. Areas for further research and conceptual development are also suggested to help resolve outstanding issues in the above areas. Despite the widespread interest in promoting SDM, there does not seem to be as yet a universally accepted consensus on the meaning of this concept.

Download Full-text