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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Shared decision making process measures and patient problems.

Sandra A Hartasanchez1, Stuart W Grande2, Victor M Montori1

  • 1Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Patient Education and Counseling
|November 22, 2021
PubMed
Summary
This summary is machine-generated.

Current observer-based shared decision making (SDM) measures capture general behaviors but miss specifics for certain SDM modes. Revised measures are needed to assess appropriate SDM mode use for patient problems.

Keywords:
MeasurementPatient centered carePurposeful SDMSDMShared decision making

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Area of Science:

  • Healthcare research
  • Clinical practice improvement
  • Patient-centered care

Background:

  • Shared decision making (SDM) is crucial for patient-centered care.
  • Purposeful SDM identifies four distinct modes based on care problems.
  • Existing observer-based SDM measures need evaluation against these modes.

Purpose of the Study:

  • To assess the applicability of current observer-based SDM measures to the four modes of Purposeful SDM.
  • To identify gaps in existing measures for specific SDM modes.

Main Methods:

  • Four coders independently evaluated 192 items from 12 observer-based SDM process measures.
  • Items were classified into 6 themes and then into one of the four Purposeful SDM modes.
  • Consensus was reached to resolve disagreements.

Main Results:

  • Items were categorized by themes: problem, roles/participation, options, preferences, decision, and evaluation.
  • Most items broadly applied to all SDM modes (191/192).
  • Few items specifically pertained to weighing (54), negotiating (5), problem-solving (0), or developing insight (0) modes.

Conclusions:

  • Observer-based SDM measures adequately cover general SDM behaviors.
  • Current measures lack sensitivity to behaviors specific to certain SDM modes.
  • Revised or new measures are needed to evaluate the appropriate use of each SDM mode.