Measuring shared decision making processes in psychiatry: Skills versus patient satisfaction

2007 ◽  
Vol 67 (1-2) ◽  
pp. 50-56 ◽  
Author(s):  
Anne Goossensen ◽  
Paula Zijlstra ◽  
Marc Koopmanschap
Keyword(s):  
Decision Making ◽  
Patient Satisfaction ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Decision Making Processes

Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law

2017 ◽  
Vol 45 (1) ◽  
pp. 12-40 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Legal Doctrine ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Decision Making Processes

The legal doctrine of informed consent has overwhelmingly failed to assure that the medical treatment patients get is the treatment patients want. This Article describes and defends an ongoing shift toward shared decision making processes incorporating the use of certified patient decision aids.

Bridging the Gap: A Priorities Assessment Tool to Support Shared Decision Making, Maximize Appointment Time, and Increase Patient Satisfaction in Women With Ovarian Cancer

2020 ◽  
Vol 16 (2) ◽  
pp. e148-e154 ◽  
Author(s):  
Melissa K. Frey ◽  
Annie Ellis ◽  
Savannah Shyne ◽  
Ryan Kahn ◽  
Eloise Chapman-Davis ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Decision Making ◽  
Patient Satisfaction ◽  
Shared Decision Making ◽  
Assessment Tool ◽  
Shared Decision ◽  
Feedback Form ◽  
Patient Centered ◽  
Symptom Index ◽  
Increase Patient Satisfaction

PURPOSE: Women with ovarian cancer identify patient-physician communication as an essential element in determining treatment course and believe a discussion about goals and values should precede treatment decisions. We sought to develop a patient-centered priorities assessment tool for women with ovarian cancer that could streamline communication, enhance treatment discussions, and increase patient satisfaction. MATERIALS AND METHODS: We designed a priorities assessment tool using a validated ovarian cancer symptom index (National Comprehensive Cancer Center–Functional Assessment of Cancer Therapy Ovarian Symptom Index-18) combined with an index to assess daily quality-of-life priorities. The tool was distributed to women with ovarian cancer in small focus group settings and online, followed by a postactivity feedback form. RESULTS: In this pilot study, 36 women completed the priorities assessment tool and 35 completed the postactivity feedback form between September 2015 and May 2016. All participants reported that the tool was easy to understand and comprehensive in scope. Twenty-nine participants (82.9%) completed the tool in 10 minutes or less. Most participants (n = 31, 86.1%) were able to stratify their priorities and identify 5 top treatment-related priorities. Participants who indicated that their goals and priorities had changed since diagnosis (n = 25, 69.4%) reported that the tool helped to identify current goals and priorities (22 [88%] of 25 participants) and would help them feel more comfortable participating in shared decision making with their medical team (21 [84%] of 25 participants). CONCLUSION: A patient-centered priorities assessment tool was easy to complete and viewed as comprehensive and useful in a pilot cohort of women with ovarian cancer. Use of a priorities assessment tool has the potential to enhance communication, promote shared decision making, and improve patient satisfaction.

Informed Shared Decision-Making and Patient Satisfaction

2014 ◽  
Vol 55 (6) ◽  
pp. 586-594 ◽  
Author(s):  
Arjan G.J. Bot ◽  
Jeroen K.J. Bossen ◽  
James H. Herndon ◽  
David E. Ruchelsman ◽  
David Ring ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Satisfaction ◽  
Shared Decision Making ◽  
Shared Decision

scholarly journals Understanding the low take-up of home-based dialysis through a shared decision-making lens: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e053937
Author(s):  
Jane Noyes ◽  
Gareth Roberts ◽  
Gail Williams ◽  
James Chess ◽  
Leah Mc Laughlin
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Healthcare Professionals ◽  
Family Members ◽  
Shared Decision ◽  
Framework Analysis ◽  
Future Treatment ◽  
Modifiable Factors ◽  
Decision Making Processes

ObjectivesTo explore how people with chronic kidney disease who are pre-dialysis, family members and healthcare professionals together navigate common shared decision-making processes and to assess how this impacts future treatment choice.DesignCoproductive qualitative study, underpinned by the Making Good Decisions in Collaboration shared decision-model. Semistructured interviews with a purposive sample from February 2019 - January 2020. Interview data were analysed using framework analysis. Coproduction of logic models/roadmaps and recommendations.SettingFive Welsh kidney services.Participants95 participants (37 patients, 19 family members and 39 professionals); 44 people supported coproduction (18 patients, 8 family members and 18 professionals).FindingsShared decision-making was too generic and clinically focused and had little impact on people getting onto home dialysis. Preferences of where, when and how to implement shared decision-making varied widely. Apathy experienced by patients, caused by lack of symptoms, denial, social circumstances and health systems issues made future treatment discussions difficult. Families had unmet and unrecognised needs, which significantly influenced patient decisions. Protocols containing treatment hierarchies and standards were understood by professionals but not translated for patients and families. Variation in dialysis treatment was discussed to match individual lifestyles. Patients and professionals were, however, defaulting to the perceived simplest option. It was easy for patients to opt for hospital-based treatments by listing important but easily modifiable factors.ConclusionsShared decision-making processes need to be individually tailored with more attention on patients who could choose a home therapy but select a different option. There are critical points in the decision-making process where changes could benefit patients. Patients need to be better educated and their preconceived ideas and misconceptions gently challenged. Healthcare professionals need to update their knowledge in order to provide the best advice and guidance. There needs to be more awareness of the costs and benefits of the various treatment options when making decisions.

Differences between women’s preferred and actual experience with ‘shared decision-making’: A mixed method study.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 34-34
Author(s):  
Deborah Ejem ◽  
J Nicholas Dionne-Odom ◽  
Danny Willis ◽  
Peter Kaufman ◽  
Laura Urquhart ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Metastatic Breast ◽  
Treatment Decision ◽  
Cancer Center ◽  
Decision Making Process ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
Actual Experience ◽  
Decision Making Processes

34 Background: Women with metastatic breast cancer (MBC) face numerous treatment and ACP decisions along their illness trajectory. We aimed to explore the treatment and ACP decision-making processes and decision support needs of women with MBC. Methods: Convergent, parallel mixed methods study (9/08-7/09). Sample included women with MBC managed by 3 breast oncologists at the Norris Cotton Cancer Center, Lebanon, NH. Participants completed a semi-structured interview and standardized decision-making instruments (decision control preferences) at study enrollment (T1; n = 22) and when they faced a decision point or 3 months later (T2; n = 19), whichever came first. Results: Participants (n = 22) where all white, averaged 62 years and were mostly married (54%), retired (45%), had a ≥ bachelor’s degree (45%), and had incomes > $40,000 (50%). On the control preferences scale, most women reported a preference for a ‘shared decision’ with clinician (T1 = 14 (64%) vs T2 = 9 (47%)) compared to making the decision themselves (T1 = 6 (27%) vs T2 = 6 (32%)), or delegating the decision to their doctor (T1 = 2 (9%) vs T2 = 4 (21%)). In semi-structured interviews about their actual treatment decision-making experience, women described experiencing a passive or delegated rather than a shared decision-making process. Conversely, women described a much more active ACP decision-making process that was often shared with family rather than their oncologists. Conclusions: Women selected a “shared” process using a validated tool; however their descriptions of the treatment decision-making processes were inconsistent with their actual experience, which was a more passive process in which they followed the oncologists’ treatment suggestions.

Shared Decision Making in Hernia Repair

2021 ◽  
Author(s):  
Paul Szotek
Keyword(s):  
Decision Making ◽  
Patient Satisfaction ◽  
Hernia Repair ◽  
Shared Decision Making ◽  
Treatment Plan ◽  
Active Role ◽  
Synthetic Mesh ◽  
Shared Decision ◽  
Before And After ◽  
Surgical Options

As the digital age of healthcare is evolving, patients are more aware, educated, and concerned about their surgical options due to access to information. Patients undergoing hernia repair are being exposed to the growing litigious environment surrounding mesh via targeted social media marketing and inorganic search engine optimization (paid SEO). As a result, we elected to implement a shared decision making (SDM) process to give our patients an active role in choosing the reinforcement material used in their repair. A cohort of 142 patients underwent the SDM process with 133 (93.7%) choosing the reinforced biologic repair (ReBAR), 8 patients (5.6%) chose permanent synthetic mesh and 1 patient (0.7%) chose a completely resorbable bio-synthetic mesh. Clinical outcomes have been similar before and after implementation of the SDM process. SDM, as has been shown in other fields of medicine, improved patient satisfaction, patient compliance, and decreased anxiety about the treatment plan. We believe that the implementation of a SDM process in hernia repair surgery will continue to result in increased patient satisfaction, reduce legal exposure, and warrants further investigation as the paradigms in the doctor-patient relationship continue to be disrupted by technology and the internet.

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