Format

Send to

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 2007 May;22(5):614-9.

What are the essential elements to enable patient participation in medical decision making?

Author information

1
VA Connecticut Healthcare System, West Haven, CT 06516, USA. liana.fraenkel@yale.edu

Abstract

BACKGROUND:

Patient participation in shared decision making (SDM) results in increased patient knowledge, adherence, and improved outcomes. Despite the benefits of the SDM model, many patients do not attain the level of participation they desire.

OBJECTIVE:

To gain a more complete understanding of the essential elements, or the prerequisites, critical to active patient participation in medical decision making from the patient's perspective.

DESIGN:

Qualitative study.

SETTING:

Individual, in-depth patient interviews were conducted until thematic saturation was reached. Two analysts independently read the transcripts and jointly developed a list of codes.

PATIENTS:

Twenty-six consecutive subjects drawn from community dwelling subjects undergoing bone density measurements.

MEASUREMENTS:

Respondents' experiences and beliefs related to patient participation in SDM.

RESULTS:

Five elements were repeatedly described by respondents as being essential to enable patient participation in medical decision making: (1) patient knowledge, (2) explicit encouragement of patient participation by physicians, (3) appreciation of the patient's responsibility/rights to play an active role in decision making, (4) awareness of choice, and (5) time.

LIMITATIONS:

The generalizability of the results is limited by the homogeneity of the study sample.

CONCLUSIONS:

Our findings have important clinical implications and suggest that several needs must be met before patients can become active participants in decisions related to their health care. These needs include ensuring that patients (1) appreciate that there is uncertainty in medicine and "buy in" to the importance of active patient participation in decisions related to their health care, (2) understand the trade-offs related to available options, and (3) have the opportunity to discuss these options with their physician to arrive at a decision concordant with their values.

PMID:
17443368
PMCID:
PMC1855272
DOI:
10.1007/s11606-007-0149-9
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Support Center