Cardiologists’ experiences and perceptions of patient involvement and communication related to shared decision-making regarding atrial fibrillation treatment

Abstract

One key to improving compliance with legislation aimed at increasing patient involvement in treatment decisions could lie in paying attention to physician-patient communication and the conditions for patient involvement in decision-making about treatment.

The Discharge Process—From a Patient’s Perspective

“…The purpose of the law is to create a better balance of patientempowerment between patients and staff, thereby enhancing patients' influence over their own health care. Published studies on patient involvement have also shown that patient involvement in their health care is a high priority, and patients' lack of determination and autonomy lead to major challenges (Elwyn & Miron-Shatz, 2010; Ij€ as-Kallio, Ruusuvuori, & Per€ akyl€ a, 2010; Siouta, Hellstr€ om Muhli, Fossum, & Karlgren, 2017). This study concerning the topic of the discharge process is relevant in today's fast pace turnover of hospital patients where patient involvement is becoming more and more central to the health policy and practice.…”

“…In accordance with the Swedish health-care system, health-care providers are obliged by law to ensure that the patient has understood the information given at hospital discharge by having a dialogue with the patient (Swedish Code of Statutes, 2017). However, many studies have shown that there are shortcomings in the discharge process regarding communication with and information provided to patients (Hesselink et al, 2014;Muhli, Trost, & Siouta, 2019;Popejoy, Moylan, & Galambos, 2009;Siouta, Hellstr€ om Muhli, Fossum, & Karlgren, 2017).…”

Patient Centeredness from a Perspective of History of the Present: A Genealogical Analysis

“…This study was conducted to explore the implications of the discursive movement. According to the discourse, both the effort to improve patients’ quality of life and the endeavor to reduce society’s costs are important driving forces in this development ( Castro et al, 2016 ; EPF, 2016 ; Hewitt-Taylor, 2015 ; Schofield et al, 2012 ; Siouta, 2016 ; Siouta et al, 2019 ; Slater, 2006 ; WHO, 2016 ). The goal is that the patient should be active and involved in all aspects of his or her own care ( Ekman et al, 2011 ; Hewitt-Taylor, 2015 ; Siouta, 2016 ; Siouta et al, 2019 ).…”

“…According to the discourse, both the effort to improve patients’ quality of life and the endeavor to reduce society’s costs are important driving forces in this development ( Castro et al, 2016 ; EPF, 2016 ; Hewitt-Taylor, 2015 ; Schofield et al, 2012 ; Siouta, 2016 ; Siouta et al, 2019 ; Slater, 2006 ; WHO, 2016 ). The goal is that the patient should be active and involved in all aspects of his or her own care ( Ekman et al, 2011 ; Hewitt-Taylor, 2015 ; Siouta, 2016 ; Siouta et al, 2019 ). This endeavor, in terms of patient centering, has influenced national guidelines and policy in various countries and organizations including the US, the UK, Australia, New Zealand, Norway, and Sweden, as well as the EU and World Health Organization (WHO) ( Broom et al, 2019 ; Hewitt-Taylor, 2015 ; Kitson et al, 2013 ).…”

“…Nor have we focused on issues such as implementation, goals, organization, resources, and results. The findings from these kinds of research include that patient-centered care models are cost-effective and that they improve patients’ experience and clinical outcomes ( Broom et al, 2019 ; Ekman et al, 2011 ; Kitson et al, 2013 ; Siouta, 2016 ; Siouta et al, 2019 ). Our main theoretical perspective was Foucault’s concept of governmentality ( 1994a ).…”