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Patient Educ Couns. 2010 Sep;80(3):358-63. doi: 10.1016/j.pec.2010.06.034. Epub 2010 Jul 27.

Inconsistencies in patient perceptions and observer ratings of shared decision making: the case of colorectal cancer screening.

Author information

1
Henry Ford Health System, Detroit, MI 48202, USA. Twunder1@hfhs.org

Abstract

OBJECTIVE:

To compare patient-reported and observer-rated shared decision making (SDM) use for colorectal cancer (CRC) screening and evaluate patient, physician and patient-reported relational communication factors associated with patient-reported use of shared CRC screening decisions.

METHODS:

Study physicians are salaried primary care providers. Patients are insured, aged 50-80 and due for CRC screening. Audio-recordings from 363 primary care visits were observer-coded for elements of SDM. A post-visit patient survey assessed patient-reported decision-making processes and relational communication during visit. Association of patient-reported SDM with observer-rated elements of SDM, as well as patient, physician and relational communication factors were evaluated using generalized estimating equations.

RESULTS:

70% of patients preferred SDM for preventive health decisions, 47% of patients reported use of a SDM process, and only one of the screening discussions included all four elements of SDM per observer ratings. Patient report of SDM use was not associated with observer-rated elements of SDM, but was significantly associated with female physician gender and patient-reported relational communication.

CONCLUSION:

Inconsistencies exist between patient reports and observer ratings of SDM for CRC screening.

PRACTICE IMPLICATIONS:

Future studies are needed to understand whether SDM that is patient-reported, observer-rated or both are associated with informed and value-concordant CRC screening decisions.

PMID:
20667678
PMCID:
PMC2971658
DOI:
10.1016/j.pec.2010.06.034
[Indexed for MEDLINE]
Free PMC Article

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