Journal
PATIENT EDUCATION AND COUNSELING
Volume 96, Issue 3, Pages 295-301Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2014.07.017
Keywords
Shared decision making; Patient perceptions; Qualitative interviews; Primary care decision-making
Funding
- University of Texas School of Public Health Cancer Education and Career Development Program (National Cancer Institute/NIH) [R25 CA57712]
- National Institute on Aging [1F31AG040923-01]
- Center for Health Communications Research at the University of Michigan [5P50CA101451-09]
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Objective: This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared. Methods: Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis. Results: Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision. Conclusion: There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of agreement may be more important than the actual decision-making process for patients to label a decision as shared. Practice implications: Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM. Published by Elsevier Ireland Ltd.
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