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MAPPIN'SDM--the multifocal approach to sharing in shared decision making.
Jürgen Kasper1, Frauke Hoffmann, Christoph Heesen
1Faculty of Mathematics, Informatics, Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany. k@sper.info
Plos One
|April 20, 2012
Summary
Shared decision making (SDM) measurement requires an inter-subjective approach. This study found observer and patient/physician perspectives on SDM indicators were uncorrelated, highlighting the need to integrate multiple viewpoints for accurate assessment.
Area of Science:
- Health Services Research
- Medical Informatics
- Patient-Centered Care
Background:
- Shared decision making (SDM) is increasingly integrated into healthcare, necessitating robust measurement tools.
- Existing SDM instruments rely on varied sub-constructs and perspectives, hindering evidence synthesis.
- A core, operable definition for SDM has been lacking, complicating the linkage of research findings.
Purpose of the Study:
- To investigate the interrelations of shared decision making (SDM) indicators assessed from multiple perspectives (observer, doctor, patient).
- To develop and validate a comprehensive inventory for capturing SDM indicators across different viewpoints and constructs.
- To address the lack of a unified approach in SDM measurement by examining agreement between different assessment perspectives.
Main Methods:
- Developed a comprehensive inventory mapping SDM judgments from observer, doctor, and patient perspectives, covering behavior and perception.
- Included novel observer foci (patient and doctor-patient-dyad) and previously neglected indicators.
- Applied the inventory to 40 consultations across 10 physicians, calculating convergent validities using Pearson correlation coefficients.
Main Results:
- High to excellent reliability was observed for all measurement scales.
- No significant correlations were found between observer judgments and those of patients or physicians.
- Moderate correlations existed between doctor and patient judgments, while high correlations were found within subjective perspectives (e.g., observer-observer).
Conclusions:
- SDM measurement necessitates integrating multiple perspectives to capture the full scope of patient involvement.
- The study underscores the importance of an inter-subjective approach for reliable and valid SDM assessment.
- Findings highlight that inter-perspective agreement in SDM does not directly correlate with SDM performance or patient activity levels.
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