Humanistic communication in the evaluation of shared decision making: A systematic review

Area of Science:

• Health Services Research
• Patient-Provider Communication
• Shared Decision Making

Background:

• Shared decision making (SDM) is crucial for patient-centered care.
• Humanistic communication, encompassing empathy, respect, and compassion, is a vital component of the patient-provider relationship.
• Existing evaluations of SDM may not adequately capture these essential humanistic elements.

Purpose of the Study:

• To systematically assess the extent and quality of humanistic communication within evaluations of shared decision making (SDM).
• To determine if current SDM assessment tools adequately measure aspects like empathy, respect, and compassion in clinical encounters.

Main Methods:

• A systematic literature search was conducted in Web of Science and Scopus for prospective studies published between 2012 and February 2018.
• Studies evaluating SDM in clinical decisions using validated measures were included.
• Reviewers extracted statements and measurement items related to humanistic communication from eligible studies and SDM instruments.

Main Results:

• Only 9% of 154 eligible studies included statements regarding humanistic communication.
• Humanistic communication was mentioned in study framing, impact measurement, patient/clinician accounts, results interpretation, and implications.
• Out of 192 items in 11 SDM measurement instruments, only 7 (3.6%) assessed humanistic communication.

Conclusions:

• Current assessments of shared decision making (SDM) predominantly focus on the technical aspects of the process.
• Humanistic elements of patient-provider communication, such as empathy and respect, are infrequently evaluated in SDM research.
• This narrow focus may limit the comprehensive understanding and implementation of patient-centered care through SDM.