[Shared decision making even for complex systemic autoimmune diseases such as Systemic Lupus Erythematosus (SLE)?]

Area of Science:

• Rheumatology
• Autoimmune Diseases
• Patient-Physician Communication

Background:

• Systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), present significant treatment challenges due to their complexity.
• Effective patient-physician communication and shared decision-making (SDM) are crucial for managing chronic conditions.

Purpose of the Study:

• To investigate the potential for implementing shared decision making (SDM) in the management of systemic autoimmune diseases.
• To explore rheumatologists' perspectives on SDM in complex cases like SLE.

Main Methods:

• Qualitative group surveys were conducted with 41 German rheumatologists.
• Standardized K&P Psychodrama® methods were employed over multiple meetings in 2012-2013.

Main Results:

• Rheumatologists value their field but face challenges from increased workload, bureaucracy, and demanding patients.
• SLE presents unique difficulties, with fear being a significant factor for both patients and physicians.
• Physicians often maintain emotional distance by focusing on professionalism and avoiding empathy.

Conclusions:

• Rheumatologists possess foundational skills for SDM.
• Specific interventions are required to equip physicians for effective SDM in complex diseases like SLE.
• Enhancing SDM for SLE patients necessitates physician-led action to address inherent challenges.