[A model of shared decision-making in medical rehabilitation]

In this article, an adjusted model of shared decision-making is presented for the sector of medical rehabilitation. This model of interaction describes shared decision-making as a process between physician and patient on the basis of shared information and with both parties equally and actively involved. The typical elements of this interaction model can be transferred to other professionals in the health care sector (i. e. therapists, nurses, social workers, etc.) as well as to the interaction between these different groups of health professionals working as a team. The idea of patient orientation is supplemented with the aspect of relations between the different groups of health professionals, hence establishing patient-oriented interaction inside the organization. In order to strengthen internal patient orientation through a process of shared decision-making between different health professionals (providers), a co-operative leadership style is required in the rehabilitation clinic. Creating the internal conditions for shared decision-making (internal patient orientation) is a prerequisite for considering needs and expectations of the patient within the treatment process (external patient orientation). Health professionals need to display the ability to create these internal conditions to allow for improvement of patient orientated treatment in terms of an integrated patient orientation. Training of the providers is a prerequisite for implementation of an integrated patient orientation in medical rehabilitation. Once a higher level of patient orientation is achieved, through participation in the provider-patient-relationship and communication between the providers within the team, an improved quality of decision-making, a higher level of patient and employee satisfaction and more positive treatment outcomes can be assumed.