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Patient Educ Couns. 2018 Nov 12. pii: S0738-3991(18)30971-6. doi: 10.1016/j.pec.2018.11.003. [Epub ahead of print]

Humanistic communication in the evaluation of shared decision making: A systematic review.

Author information

1
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: Kunneman.Marleen@mayo.edu.
2
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; Center for Pharmacy Innovation and Outcomes, Geisinger, Forty Fort, PA, USA. Electronic address: MGionfriddo@geisinger.edu.
3
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA. Electronic address: TolozaBonilla.Freddy@mayo.edu.
4
Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: F.R.Gaertner@lumc.nl.
5
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; University of Puerto Rico School of Medicine, San Juan, PR, USA. Electronic address: Bonilla.Gabriella@mayo.edu.
6
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA. Electronic address: Hargraves.Ian@mayo.edu.
7
Mayo Medical Libraries, Mayo Clinic, Rochester, MN, USA. Electronic address: Erwin.Patricia@mayo.edu.
8
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA. Electronic address: Montori.Victor@mayo.edu.

Abstract

OBJECTIVE:

To assess the extent to which evaluations of shared decision making (SDM) assess the extent and quality of humanistic communication (i.e., respect, compassion, empathy).

METHODS:

We systematically searched Web of Science and Scopus for prospective studies published between 2012 and February 2018 that evaluated SDM in actual clinical decisions using validated SDM measures. Two reviewers working independently and in duplicate extracted all statements from eligible studies and all items from SDM measurement instruments that referred to humanistic patient-clinician communication.

RESULTS:

Of the 154 eligible studies, 14 (9%) included ≥1 statements regarding humanistic communication, either in framing the study (N = 2), measuring impact (e.g., empathy, respect, interpersonal skills; N = 9), as patients'/clinicians' accounts of SDM (N = 2), in interpreting study results (N = 3), and in discussing implications of study findings (N = 3). Of the 192 items within the 11 SDM measurement instruments deployed in the included studies, 7 (3.6%) items assessed humanistic communication.

CONCLUSION:

Assessments of the quality of SDM focus narrowly on SDM technique and rarely assess humanistic aspects of patient-clinician communication.

PRACTICE IMPLICATIONS:

Considering SDM as merely a technique may reduce SDM's patient-centeredness and undermine its' contribution to patient care.

KEYWORDS:

Communication; Humanism; Patient involvement; Shared decision making

PMID:
30458971
DOI:
10.1016/j.pec.2018.11.003

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