Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions

Zisman‐Ilani, Yaara; Obeidat, Rana; Fang, Lauren; Hsieh, Sarah; Berger, Zackary

doi:10.2196/18223

Cited by 17 publications

(15 citation statements)

References 40 publications

(44 reference statements)

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“…A study by Zisman-Ilani et. al, revealed several issues related to the patient-physician relationship such as lack of time and training, the role of insurance companies, the incentive structure, and lack of support for physicians [ 14 ]. Another study investigating the barriers to communication between family physicians and patients in Dubai showed that female patients experience more time limitations during consultation where not all their issues are addressed as compared to their male counterparts [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

et al. 2022

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Background Delivering patient-centered care is a declared objective of many health delivery systems globally, especially in an era of value-based health care. It entails the active engagement of the patients in healthcare decisions related to their health, also known as shared decision making (SDM). Little is known about the role of gender in shaping the perspective of patients on their opportunity for engaging in SDM in the Arabian Gulf Region. The aim of this study is to investigate the role of gender in shaping patients’ perspectives toward their opportunity for SDM in Dubai, UAE. Methods This study utilized a cross-sectional survey consisting of sociodemographic questions and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9). A total of 50 physicians (25 females and 25 males), practicing at a large private healthcare delivery network in Dubai, were recruited using convenience sampling. Ten patients of every recruited physician (5 male and 5 female) were surveyed (i.e., a total of 500 patients). Statistical analysis assessed the differences in patients’ perceptions of physician SDM attitude scores by physicians’ and patients’ gender using independent t-test, ANOVA-test, and Chi-square analyses. Findings A total of 50 physicians and 500 patients (250 male patients and 250 female patients) participated in this study. The odd of patients agreement was significantly lower for male physicians, compared to their female counterparts, on the following elements of SDM: the doctor precisely explaining the advantages and disadvantages of the treatment (OR = 0.55, 95%CI: 0.34–0.88, p = 0.012); the doctor helping them understand the information (OR = 0.47, 95%CI: 0.23–0.97, p = 0.038), the doctor asking about preferred treatment option (OR = 0.52, 95%CI: 0.35–0.77, p = 0.001), and the doctor thoroughly weighting the different treatment options (OR = 0.60, 95%CI: 0.41–0.90, p = 0.013). No significant associations were observed between patients’ gender and their perception of their opportunity for SDM. Likewise, no significant associations were observed between the same or different physician-patient gender and patients’ perception of physicians’ SDM attitudes. Statistically significant associations were observed between physician-patient gender and preferred treatment option for patients (p = 0.012). Conclusion Study findings suggest that while there were no differences in patients’ perspective on SDM by the gender of patients, significant differences were observed by the gender of physicians. Female physicians, compared to their male counterparts, were more engaged in SDM, with both male and female patients. Male physician-female patient dyad received the lowest scores on SDM. This could be explained by the cultural, social, and religious sensitivities that infiltrate the physician-patient relationship in the Arab contexts. Despite the multi-cultural nature of the country, some female patients may still experience some discomfort in opening up and in discussion preferences with male physicians. For physicians, striking the right balance between assertiveness and SDM is necessary within the cultural context, especially among male providers. Offering targeted learning and development programs on the importance and practice of SDM is also necessary to ensure equitable opportunity for engagement in SDM for all patients irrespective of the gender of their provider.

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Section: Introductionmentioning

confidence: 99%

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

et al. 2022

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“…The recommendations are also strongly biased toward Western countries and culture, as well as being White or belonging to a majority group. [58][59][60][61] Considering the international impact of NICE guidelines on SDM practice, and since many studies of SDM in mental health fall outside of the NICE inclusion criteria, we worry that this narrow representation of SDM will become the gold standard, overlooking other effective research and interventions of SDM in mental health. For example, the NICE guidelines ignore the concept of shared advance decision making in mental health, SDM around decisions about advance care planning 62,63 and the significant body of literature in mental health around the Joint Crisis Plan.…”

Section: Bias In Addressing Cultural Differences In Sdm Practicementioning

confidence: 99%

NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

et al. 2021

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“… 81 Nearly half of the studies included originated either from Canada or the United States, which is significant as Canada and the United States are the world’s leading researchers of SDM. 82 To bring this into perspective, Ottawa Hospital Research Institute in Canada ( www.decisionaid.ohri.ca/index.html ), EBSCO information services in the United States ( www.ebsco.com/ ), and Mayo Clinic SDM National Resource Centre ( www.shareddecisions.mayoclinic.org/ ) all established websites related to PDAs, which have been widely spread all over the world.…”

Section: Discussionmentioning

confidence: 99%

Shared Decision-Making in Breast Reconstruction for Breast Cancer Patients: A Scoping Review

Li¹,

Meng²,

Zhao³

et al. 2021

PPA

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For most breast cancer (BC) patients who have undergone a mastectomy, the decision whether to proceed with breast reconstruction (BR) is complicated and requires deliberation. Shared decision-making (SDM) helps to address those needs and promote informed value-based decisions. However, little is known about the SDM status for BR in BC patients. This scoping review describes: 1) basic characteristics of studies on BR SDM in BC patients; 2) factors influencing BR SDM in BC patients; 3) experience and perception of BR SDM in BC patients; and 4) outcome measures reported. This review was performed in accordance with the Arksey and O’Malley methodology. A total of 5 English and 4 Chinese databases were searched, as well as different sources from grey literature. The data extraction form was developed by referring to the objectives and the Ottawa Decision Support Framework (ODSF). Data was analyzed using thematic analysis, framework analysis and descriptive statistics, with findings presented in the tables and diagrams. A total of 1481 records were retrieved and 42 of these included after screening. In 21 (21/42, 50%) of the studies, patient decision aids (PDAs) were utilized, and in 17 (17/42, 40.48%) of the studies, the factors influencing the implementation of SDM were explored. Of these 17 studies, the factors influencing the implementation of SDM were categorized into the following: the patient level (17/17, 100%), the healthcare level (2/17, 11.76%) and the organizational and system level (7/17, 41.18%). A total of 8 (19.05%) of the 42 studies focused on patients’ experiences and perceptions of SDM, and all studies used qualitative research methods. Of these 8 studies, a total of 7 (7/8, 87.50%) focused on patients’ experiences of SDM participation, and 4 (4/8, 50.00%) focused on patients’ perceptions of SDM. A total of 24 studies (24/42, 57.14%) involved quantitative outcome measures, where 49 items were divided into three classifications according to the outcomes of ODSF: the quality of the decision (17/24, 70.83%), the quality of the decision-making process (20/24, 83.33%), and impact (13/24, 54.17%). Although researchers have paid less attention to other research points in the field of SDM, compared to the design and application of SDM interventional tools, the research team still presents some equally noteworthy points through scoping review. For instance, the various factors influencing BC patients’ participation in SDM for BR (especially at the healthcare provider level and at the organizational system level), patients’ experiences and perceptions. Systematic reviews (SRs) should be conducted to quantify the impact of these different factors on BR SDM. Implementation of scientific theories and methods can inform the exploration and integration of these factors.

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Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions

Cited by 17 publications

References 40 publications

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

Shared Decision-Making in Breast Reconstruction for Breast Cancer Patients: A Scoping Review

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