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The problematic of decision-sharing: deconstructing 'cholesterol' in a clinical encounter
Richard Gwyn1, Glyn Elwyn, Adrian Edwards
1Health Communication Research Centre, School of English, Communication and Philosophy, Cardiff University, Cardiff, UK. gwyn@cf.ac.uk
Summary
Clinicians face challenges in shared decision-making due to patient difficulties with risk understanding. This study explores professional agency versus transparent risk communication for better patient outcomes.
Area of Science:
- Medical Communication
- Health Psychology
- Discourse Analysis
Background:
- Shared decision-making is advocated but faces practical barriers.
- Patients struggle to comprehend health risks, especially with emotionally charged terms.
- Clinicians must balance informing patients with guiding decisions.
Purpose of the Study:
- To analyze clinical discourse on risk communication and shared decision-making.
- To explore the concept of 'professional agency' in patient consultations.
- To provide insights into effective risk communication strategies.
Main Methods:
- Discourse analytic exploration of a clinical interaction.
- Application of Bakhtin's theory of dialogism.
- Qualitative analysis of patient-clinician communication.
Main Results:
- Emotional language significantly impacts patient understanding of health risks.
- Direct risk communication can be challenging due to patient cognitive biases.
- Professional agency may sometimes be perceived as necessary to guide patients.
Conclusions:
- Effective shared decision-making requires nuanced approaches to risk communication.
- Understanding patient reception of probabilistic information is crucial.
- Further research is needed on balancing transparency and guidance in clinical practice.