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Patient Educ Couns. 2014 Sep;96(3):295-301. doi: 10.1016/j.pec.2014.07.017. Epub 2014 Jul 21.

Understanding patient perceptions of shared decision making.

Author information

1
Center for Health Promotions and Research, University of Texas School of Public Health, San Antonio, USA. Electronic address: Laura.Aubree.Shay@uth.tmc.edu.
2
Massey Cancer Center and Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, USA.

Abstract

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.

KEYWORDS:

Patient perceptions; Primary care decision-making; Qualitative interviews; Shared decision making

PMID:
25097150
PMCID:
PMC4241759
DOI:
10.1016/j.pec.2014.07.017
[Indexed for MEDLINE]
Free PMC Article

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