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How option-listing influences decision-making in orthopedic consultations: a conversation analytic study.
A C Anouk Van der Hout1, Mike Huiskes2, Taco Gosens3
1Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, the Netherlands.
Patient Education and Counseling
|September 27, 2024
Summary
Orthopedic surgeons use option-listing to aid shared decision-making (SDM) in hip and knee osteoarthritis care. This technique presents treatment options hierarchically, allowing patients to express preferences while acknowledging the surgeon's professional opinion.
Area of Science:
- Orthopedics
- Medical Communication
- Health Services Research
Background:
- Shared decision-making (SDM) is crucial for patient-centered orthopedic care.
- Option-listing is a communication technique that can facilitate SDM.
Purpose of the Study:
- To examine the specific practices orthopedic surgeons employ when using option-listing.
- To understand how these practices influence shared decision-making in consultations for hip and knee osteoarthritis.
Main Methods:
- Conversation analysis of 35 orthopedic consultations.
- Focus on interactions between newly referred patients with hip/knee osteoarthritis and their orthopedists.
Main Results:
- Orthopedists use two principles for option-listing: a fixed, scaled order of treatments and presenting options relationally.
- This structure allows surgeons to convey professional judgment and patients to co-construct the list, sometimes by deferring to the surgeon's stance.
Conclusions:
- Option-listing can enhance SDM by enabling patient choice, but it may position patients to respond to the surgeon's expressed opinion.
- Patients can leverage the scaled presentation of options to voice their own treatment preferences.
- Understanding these interactional dynamics can optimize the use of option-listing for improved SDM.
Keywords:
Conversation analysisMedical interactionOption-listingOrthopedic surgeryShared decision-makingMore Related Videos
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