Mutual influence in shared decision making: a collaborative study of patients and physicians

Mutual influence in shared decision making: a collaborative study of patients and physicians Objective To explore how patients and physicians describe attitudes and behaviours that facilitate shared decision making. Background Studies have described physician behaviours in shared decision making, explored decision aids for informing patients and queried whether patients and physicians want to share decisions. Little attention has been paid to patients’ behaviors that facilitate shared decision making or to the influence of patients and physicians on each other during this process. Methods Qualitative analysis of data from four research work groups, each composed of patients with chronic conditions and primary care physicians. Results Eighty‐five patients and physicians identified six categories of paired physician/patient themes, including act in a relational way; explore/express patient’s feelings and preferences; discuss information and options; seek information, support and advice; share control and negotiate a decision; and patients act on their own behalf and physicians act on behalf of the patient. Similar attitudes and behaviours were described for both patients and physicians. Participants described a dynamic process in which patients and physicians influence each other throughout shared decision making. Conclusions This study is unique in that clinicians and patients collaboratively defined and described attitudes and behaviours that facilitate shared decision making and expand previous descriptions, particularly of patient attitudes and behaviours that facilitate shared decision making. Study participants described relational, contextual and affective behaviours and attitudes for both patients and physicians, and explicitly discussed sharing control and negotiation. The complementary, interactive behaviours described in the themes for both patients and physicians illustrate mutual influence of patients and physicians on each other. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Health Expectations Wiley

Mutual influence in shared decision making: a collaborative study of patients and physicians

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Publisher
Wiley
Copyright
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
ISSN
1369-6513
eISSN
1369-7625
DOI
10.1111/j.1369-7625.2008.00525.x
Publisher site
See Article on Publisher Site

Abstract

Objective To explore how patients and physicians describe attitudes and behaviours that facilitate shared decision making. Background Studies have described physician behaviours in shared decision making, explored decision aids for informing patients and queried whether patients and physicians want to share decisions. Little attention has been paid to patients’ behaviors that facilitate shared decision making or to the influence of patients and physicians on each other during this process. Methods Qualitative analysis of data from four research work groups, each composed of patients with chronic conditions and primary care physicians. Results Eighty‐five patients and physicians identified six categories of paired physician/patient themes, including act in a relational way; explore/express patient’s feelings and preferences; discuss information and options; seek information, support and advice; share control and negotiate a decision; and patients act on their own behalf and physicians act on behalf of the patient. Similar attitudes and behaviours were described for both patients and physicians. Participants described a dynamic process in which patients and physicians influence each other throughout shared decision making. Conclusions This study is unique in that clinicians and patients collaboratively defined and described attitudes and behaviours that facilitate shared decision making and expand previous descriptions, particularly of patient attitudes and behaviours that facilitate shared decision making. Study participants described relational, contextual and affective behaviours and attitudes for both patients and physicians, and explicitly discussed sharing control and negotiation. The complementary, interactive behaviours described in the themes for both patients and physicians illustrate mutual influence of patients and physicians on each other.

Journal

Health ExpectationsWiley

Published: Jun 1, 2009

References

  • Shared decision‐making in the medical encounter: what does it mean? (Or it takes at least two to tango)
    Charles, Charles; Gafni, Gafni; Whelan, Whelan
  • The rhetoric of informed choice: perspectives from midwives on intrapartum fetal heart rate monitoring
    Hindley, Hindley; Thomson, Thomson
  • Physician responses to ambiguous patient symptoms
    Seaburn, Seaburn; Morse, Morse; McDaniel, McDaniel; Beckman, Beckman; Silberman, Silberman; Epstein, Epstein
  • Putting informed and shared decision making into practice
    Towle, Towle; Godolphin, Godolphin; Grams, Grams; Lamarre, Lamarre
  • Patient views on choice and participation in primary health care
    Rosen, Rosen; Anell, Anell; Hjortsberg, Hjortsberg
  • Participation preferences of patients with acute and chronic conditions
    Hamann, Hamann; Neuner, Neuner; Kasper, Kasper
  • Involvement in treatment decision‐making: its meaning to people with diabetes and implications for conceptualisation
    Entwistle, Entwistle; Prior, Prior; Skea, Skea; Francis, Francis
  • Patient–doctor decision‐making about treatment within the consultation – a critical analysis of models
    Wirtz, Wirtz; Cribb, Cribb; Barber, Barber
  • Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice
    Elwyn, Elwyn; Edwards, Edwards; Hood, Hood
  • Communication patterns of primary care physicians
    Roter, Roter; Stewart, Stewart; Putnam, Putnam; Lipkin, Lipkin; Stiles, Stiles; Inui, Inui
  • Patient participation in decision‐making
    Guadagnoli, Guadagnoli; Ward, Ward

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