Fundamentals of Shared Decision-Making in Surgery

Area of Science:

• Surgical Oncology
• Patient-Centered Care
• Health Services Research

Background:

• Shared decision-making (SDM) is crucial for patient-centered care in complex colorectal surgery.
• Treatment decisions in this field involve significant tradeoffs, necessitating patient involvement.

Purpose of the Study:

• To review the principles, benefits, and challenges of SDM in surgical contexts, particularly colorectal surgery.
• To emphasize SDM's role in aligning clinical decisions with patient values and preferences.

Main Methods:

• This study is a review of existing literature on SDM in surgical settings.
• It synthesizes information on SDM principles, validated tools, frameworks, and decision aids in colorectal cancer care.

Main Results:

• SDM enhances patient knowledge, reduces decisional conflict and regret, and improves satisfaction and adherence.
• Systemic benefits include reduced preference-sensitive surgeries and potential cost savings.
• Barriers include limited health literacy, time constraints, and clinician discomfort with uncertainty.

Conclusions:

• Advancing SDM in colorectal surgery requires clinician training, patient engagement, and culturally sensitive communication.
• Future research should focus on pragmatic trials and integrating SDM metrics into clinical workflows.