Mutual influence in shared decision making: a collaborative study of patients and physicians

Area of Science:

• Healthcare research
• Patient-physician communication
• Shared decision-making

Background:

• Previous research focused on physician behaviors and decision aids.
• Limited understanding of patient behaviors facilitating shared decision-making.
• The mutual influence between patients and physicians in this process was underexplored.

Purpose of the Study:

• To explore patient and physician perspectives on attitudes and behaviors that enable shared decision-making.
• To identify how patients and physicians influence each other during shared decision-making.

Main Methods:

• Qualitative analysis of data from four research work groups.
• Involved patients with chronic conditions and primary care physicians.

Main Results:

• Identified six paired physician/patient themes: relational interaction, expressing feelings/preferences, discussing information, seeking advice, sharing control, and acting on behalf of each other.
• Similar attitudes and behaviors were reported by both patients and physicians.
• Described a dynamic process of mutual influence throughout shared decision-making.

Conclusions:

• This study uniquely involved collaborative definition of shared decision-making behaviors by clinicians and patients.
• Expanded understanding of patient attitudes and behaviors that facilitate shared decision-making.
• Highlighted relational, contextual, and affective elements, emphasizing mutual influence and negotiation.