Challenges in promoting shared decision-making: Towards a breakthrough in Japan

Article Public, Environmental & Occupational Health

Facilitators and barriers to implementing shared decision making: A cross-sectional study of physicians in Japan

Teruchika Koyama et al.

Summary: This cross-sectional study in Japan aimed to identify the facilitators and barriers to implementing shared decision making (SDM) and explore the potential effect modification by hospital types. The study found that physicians' attitude, injunctive norm, intention, and habit were significant facilitators, while unfavorable attitude, lack of self-efficacy, knowledge, salience, and experience were significant barriers to SDM implementation. Additionally, experiential attitude, injunctive norm, and physician's habit were identified as significant facilitators for physicians working in university hospitals compared to those working in municipal hospitals.

PATIENT EDUCATION AND COUNSELING (2022)

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Article Medical Informatics

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

Yuko Goto et al.

Summary: In Japan, there is an increasing number of older people with health problems requiring patient-centered care. This study adapted the 9-item Shared Decision Making Questionnaire for use with healthcare professionals other than physicians. The new Care SDM-Questionnaires showed high internal consistency and similar structures to the original physician versions, indicating their potential usefulness in training settings.

BMC MEDICAL INFORMATICS AND DECISION MAKING (2021)

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Review Medicine, Research & Experimental

The reality of informed consent: empirical studies on patient comprehension-systematic review

Tomasz Pietrzykowski et al.

Summary: Research indicates that patients' comprehension of fundamental informed consent components is limited, particularly in terms of placebo concepts, randomisation, safety issues, risks, and side effects. This lack of understanding may impact patients' genuine involvement in shared medical decision-making.

TRIALS (2021)

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Article Multidisciplinary Sciences

Association between physicians' and patients' perspectives of shared decision making in primary care settings in Japan: The impact of environmental factors

Yuko Goto et al.

Summary: The study aimed to create a Japanese version of the SDM-Q-Doc scale to assess SDM from the perspective of physicians, confirm its internal consistency and validity, and identify the positive role of nurse's attendance in physician-patient consultations in facilitating SDM.

PLOS ONE (2021)

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Article Urology & Nephrology

Shared decision making for the initiation and continuation of dialysis: a proposal from the Japanese Society for Dialysis Therapy

Kazuyoshi Okada et al.

Summary: The JSDT revised the proposal in 2020 to guide healthcare teams in providing the best healthcare management and care respecting the patient's will through advance care planning and shared decision making. This includes conservative kidney management for all end-stage kidney disease patients, regardless of terminal stage or dementia. The proposal is consensus-based rather than evidence-based, which means healthcare teams may not be legally exempt if implementing the policies results in the patient's death.

RENAL REPLACEMENT THERAPY (2021)

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Review Geriatrics & Gerontology