Cross-cultural Interactions and Shared Decision-making

Derrington, Sabrina; Paquette, Erin Talati; Johnson, Khaliah

doi:10.1542/peds.2018-0516j

Cited by 42 publications

(26 citation statements)

References 24 publications

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“…A qualitative study conducted to analyse the perspectives of US paediatricians regarding shared decision-making in ADHD showed that instead of familiarizing families with all the options first, the paediatricians provided information to persuade families to accept the treatment of their choice [ 70 ]. These different scenarios can be explained in part by the quality of communication between the physician and the patient/parent, the technical language used, and possibly the cultural context of both parties [ 71 ] as well as the development of medical bioethics and doctor–patient communication skills [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

et al. 2020

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Background Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy. Methods A self-report study on communication patterns in a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors. Results A high prevalence (68.7% [95% CI 60.0–70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16–2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11–2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71–19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed. Conclusions Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

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Section: Discussionmentioning

confidence: 99%

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A qualitative study conducted to analyse the perspectives of U.S. paediatricians regarding shared decision-making in ADHD indicated that instead of familiarizing families with all the options rst, the paediatricians provided information to persuade families to accept the treatment of their choice [73]. These different scenarios can be explained in part by the quality of communication between the physician and the patient/parent, the technical language used and possibly the cultural context of both parties [74] as well as the development of medical bioethics and doctor-patient communication skills [75].…”

Section: Discussionmentioning

confidence: 99%

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

Lazcano-Ponce

Ángeles-Llerenas

Rodríguez-Valentín

et al. 2020

Preprint

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Abstract Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomism. Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors. Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomism were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomism (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomism was observed. Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomism. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

show abstract

“…A qualitative study conducted to analyse the perspectives of US paediatricians regarding shared decision-making in ADHD indicated that instead of familiarizing families with all the options rst, the paediatricians provided information to persuade families to accept the treatment of their choice [70]. These different scenarios can be explained in part by the quality of communication between the physician and the patient/parent, the technical language used and possibly the cultural context of both parties [71] as well as the development of medical bioethics and doctor-patient communication skills [72].…”

Section: Discussionmentioning

confidence: 99%

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

Lazcano-Ponce

Ángeles-Llerenas

Rodríguez-Valentín

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomy.Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors. Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed.Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

show abstract

Cross-cultural Interactions and Shared Decision-making

Cited by 42 publications

References 24 publications

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

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