Effectiveness of the DECIDE Interventions on Shared Decision Making and Perceived Quality of Care in Behavioral Health With Multicultural Patients

Alegrı́a, Margarita; Nakash, Ora; Johnson, Kirsten; Ault-Brutus, Andrea; Carson, Nicholas; Fillbrunn, Mirko; Wang, Ye; Cheng, A.; Harris, Treniece Lewis; Polo, Antonio J.; Lincoln, Alisa K.; Freeman, Elmer; Bostdorf, Benjamin; Rosenbaum, M.; Epelbaum, C.; LaRoche, Martin; Okpokwasili-Johnson, Ebele; Carrasco, Ma Jose; Shrout, Patrick E.

doi:10.1001/jamapsychiatry.2017.4585

Cited by 51 publications

(45 citation statements)

References 65 publications

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“…Subsequently, the effectiveness of these interventions and this shared decision-making process need to be studied. Patient-reported outcome measures such as quality of life, satisfaction with care or absence of decisional conflict may reflect on the success of the process 101–103. Other indicators may include indirect evidence such as the proportion of patients withdrawing from treatment pathways after initial selection or starting treatment.…”

Section: Discussionmentioning

confidence: 99%

Discussions during shared decision-making in older adults with advanced renal disease: a scoping review

et al. 2019

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ObjectivesThis review summarises the information available for clinicians counselling older patients with kidney failure about treatment options, focusing on prognosis, quality of life, the lived experiences of treatment and the information needs of older adults.DesignWe followed the Joanna Briggs Institute Methodology for Scoping Reviews. The final report conforms to the PRISMA-ScR guidelines.Data sourcesPubMed, PsycINFO, CINAHL, Embase, Scopus, Web of Science, TRIP and online repositories (for dissertations, guidelines and recommendations from national renal associations).Eligibility criteria for inclusionArticles in English studying older adults with advanced kidney disease (estimated glomerular filtration rate <30 mL/min/1.73 m2); published between January 2000 and August 2018. Articles not addressing older patients separately or those comparing between dialysis modalities were excluded.Data extraction and synthesisTwo independent reviewers screened articles for inclusion and grouped them by topic as per the objectives above. Quantitative data were presented as tables and charts; qualitative themes were identified and described.Results248 articles were included after screening 15 445 initial results. We summarised prognostic scores and compared dialysis and non-dialytic care. We highlighted potentially modifiable factors affecting quality of life. From reports of the lived experiences, we documented the effects of symptoms, of ageing, the feelings of disempowerment and the need for adaptation. Exploration of information needs suggested that patients want to participate in decision-making and need information, in simple terms, about survival and non-survival outcomes.ConclusionWhen discussing treatment options, validated prognostic scores are useful. Older patients with multiple comorbidities do not do well with dialysis. The modifiable factors contributing to the low quality of life in this cohort deserve attention. Older patients suffer a high symptom burden and functional deterioration; they have to cope with significant life changes and feelings of disempowerment. They desire greater involvement and more information about illness, symptoms and what to expect with treatment.

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Section: Discussionmentioning

confidence: 99%

Discussions during shared decision-making in older adults with advanced renal disease: a scoping review

et al. 2019

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“…Additionally, introducing shared decision‐making strategies in pre‐licensure education will ensure a workforce that is equipped for engaging all key stakeholders with patients as they make healthcare decisions. Nurses can also develop skills in helping patients and caregivers navigate shared decision‐making aids which support more informed treatment and care decisions (Alegria et al., ).…”

Section: Educationmentioning

confidence: 99%

Family caregivers: Important but often poorly understood

Davidson

Abshire

Paull

et al. 2018

Journal of Clinical Nursing

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“…Leppin and colleagues have explored this approach with a toolkit to facilitate the cross‐organizational spread and scale of a shared decision making intervention called the Statin Choice Conversation Aid to support the recommended shared decision making approach in determining whether to use statins to prevent cardiovascular events in at‐risk patients . Training and capacity building, supported by specifically designed aids, in both health care professionals and patient has the potential to improve shared decision making and the patient‐reported quality of care . Shared decision making is about autonomy, relational autonomy, patient‐centered care, communication, and interpersonal relationship, so these information packages are a support to capacitate health care professionals to communicate effectively, mentioning all relevant details, act ethically, guaranteeing that patients and their families are adequately involved in the decisions that pertain to their health, and develop intercultural competences, by facilitating the understanding of cultural differences and suggesting more inclusive strategies.…”

Section: Discussionmentioning

confidence: 99%

“…14 Training and capacity building, supported by specifically designed aids, in both health care professionals and patient has the potential to improve shared decision making and the patient-reported quality of care. 15 Shared decision making is about autonomy, relational autonomy, patient-centered care, communication, and interpersonal relationship, so these information packages are a support to capacitate health care professionals to communicate effectively, mentioning all relevant details, act ethically, guaranteeing that patients and their families are adequately involved in the decisions that pertain to their health, and develop intercultural competences, by facilitating the understanding of cultural differences and suggesting more inclusive strategies. The effectiveness of the approach is greatly improved by an organization-wide adoption, with the aid of specific training for the providers.…”

Section: Discussionmentioning

confidence: 99%

Overview of the main challenges in shared decision making in a multicultural and diverse society in the intensive and critical care setting

Giuliani

Melegari

Carrieri

et al. 2019

Evaluation Clinical Practice

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Background In shared decision making, health care professionals and patients collaborate in making health‐related choices. This process is based on autonomy and constitutes one to the elements of patient‐centered care. However, there are situations where shared decision making is more difficult, if not impossible, due to barriers, which may be related to language, culture, education, or mental capacity and external factors like the state of emergency or the availability of alternative sources of information. Aim The aim of this paper is to identify some of the main obstacles to the adoption of shared decision making in an intensive and critical care scenario and discuss potential ways to facilitate its implementation. Methods We conducted a literature review on shared decision making from the perspective of intensive and critical care specialists. Discussion Although the health care context is complex and the variety of situation that can arise makes it impossible to prepare professionals for every occurrence, shared decision making process should be structured at an organization level, engaging health care professionals, experts of communication, and patient representatives coming from different cultural backgrounds, languages, and education to assemble for all the main procedures, where shared decision making is involved, the specific information packages health care professionals will use in order to guide them through the process and ensuring all patients receive a comparable level of engagement. Shared decision making should not become a hindrance for the health care professional but on the contrary a way to strengthen their relationship with the patient. Conclusion The implementation of the shared decision making approach at an organization‐wide level improves its quality and effectiveness.

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Effectiveness of the DECIDE Interventions on Shared Decision Making and Perceived Quality of Care in Behavioral Health With Multicultural Patients

Abstract: clinicaltrials.gov Identifier: NCT01947283.

Cited by 51 publications

References 65 publications

Discussions during shared decision-making in older adults with advanced renal disease: a scoping review

Discussions during shared decision-making in older adults with advanced renal disease: a scoping review

Family caregivers: Important but often poorly understood

Overview of the main challenges in shared decision making in a multicultural and diverse society in the intensive and critical care setting

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