Biomaterial Database

Eliciting patient preferences in shared decision-making (SDM): Comparing conversation analysis and SDM measurements. 2017

Anne Marie Dalby Landmark, and Eirik Hugaas Ofstad, and Jan Svennevig

MultiLing Center for Research on Multilingualism in Society across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway; HØKH Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway. Electronic address: a.m.landmark@iln.uio.no.

OBJECTIVE To explore how physicians bring up patient preferences, and how it aligns with assessments of shared decision-making. METHODS Qualitative conversation analysis of physicians formulating hypotheses about the patient's treatment preference was compared with quantitative scores on SDM and 'patient preferences' using OPTION(5) and MAPPIN'SDM. RESULTS Physicians occasionally formulate hypotheses about patients' preferences and then present a treatment option on the basis of that ("if you think X+we can do Y"). This practice may promote SDM in that the decisions are treated as contingent on patient preferences. However, the way these hypotheses are formulated, simultaneously constrains the patient's freedom of choice and exerts a pressure to accept the physician's recommendation. These opposing effects may in part explain cases where different assessment instruments yield large variations in SDM measures. CONCLUSIONS Eliciting patient preferences is a complex phenomenon that can be difficult to reduce into an accurate number. Detailed analysis can shed light on how patient preferences are elicited, and its consequences for patient involvement. Comparing CA and SDM measurements can contribute to specifying communicative actions that SDM scores are based on. CONCLUSIONS Our findings have implications for SDM communication skills training and further development of SDM measurements.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D009664	Norway	A country located in northern Europe, bordering the North Sea and the Atlantic Ocean, west of Sweden. The capital is Oslo.	Kingdom of Norway
D010358	Patient Participation	Patient involvement in the decision-making process in matters pertaining to health.	Patient Activation,Patient Empowerment,Patient Engagement,Patient Involvement,Patient Participation Rates,Activation, Patient,Empowerment, Patient,Engagement, Patient,Involvement, Patient,Participation Rate, Patient,Participation Rates, Patient,Participation, Patient,Patient Participation Rate
D010817	Physician-Patient Relations	The interactions between physician and patient.	Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D003657	Decision Making	The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.	Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D001291	Attitude of Health Personnel	Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.	Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes
D014741	Video Recording	The storing or preserving of video signals to be played back later via a transmitter or receiver.	Audiovisual Recording,Videorecording,Audiovisual Recordings,Recording, Audiovisual,Recording, Video,Recordings, Audiovisual,Recordings, Video,Video Recordings,Videorecordings