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A Practical Guideline for the Implementation of Shared Decision-making in Complex Ventral Incisional Hernia Repair
Bradley Kushner1, Timothy Holden2, Mary Politi3
1Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
The Journal of Surgical Research
|October 19, 2020
Summary
Shared decision-making (SDM) enhances patient-centered care for ventral incisional hernia repair (VIHR). Implementing SDM ensures treatments align with patient goals, improving outcomes and quality of life.
Area of Science:
- Surgical decision-making
- Patient-centered care
- Medical ethics
Background:
- Current consent processes for ventral incisional hernia repair (VIHR) are often unidirectional, not collaborative.
- Shared decision-making (SDM) involves a dialog to understand and incorporate patient preferences.
- Limited literature exists on applying SDM to VIHR, despite its suitability.
Purpose of the Study:
- To provide evidence-based guidelines for integrating SDM into VIHR care.
- To highlight the benefits of SDM for VIHR patients.
- To address the complexity of VIHR decision-making.
Main Methods:
- Literature review on SDM in surgery.
- Analysis of practice experience in VIHR.
- Development of practical guidelines for SDM implementation.
Main Results:
- Evidence supports SDM's application in surgical contexts.
- SDM can be effectively applied to VIHR, considering its complex factors.
- An example framework (SHARE) for SDM in VIHR was illustrated.
Conclusions:
- SDM can improve patient-centered and preference-concordant care in VIHR.
- Treatment interventions guided by SDM align with patient goals.
- SDM enhances the overall quality of care for VIHR patients.
