Shared decision-making in back pain consultations: an illusion or reality?

Abstract

Purpose Amid a political agenda for patient-centred healthcare, shared decision-making is reported to substantially improve patient experience, adherence to treatment and health outcomes. However, observational studies have shown that shared decision-making is rarely implemented in practice. The purpose of this study was to measure the prevalence of shared decision-making in clinical encounters involving physiotherapists and patients with back pain.Method Eighty outpatient encounters (comprising 40 h of data) were observed audio-recorded, transcribed verbatim and analysed using the 12-item OPTION scale. The higher the score, the greater is the shared decision-making competency of the clinicians. Results The mean OPTION score was 24.0 % (range 10.4-43.8 %). Conclusion Shared decision-making was under-developed in the observed back pain consultations. Clinicians' strong desire to treat acted as a barrier to shared decisionmaking and further work should focus on when and how it can be implemented.

Women’s experiences and satisfaction with having a cesarean birth: An integrative review

“…As noted in Introduction, shared decision-making refers to a collaborative process where the clinician provides the patient (woman in this context) with evidence-based information to support patients' active involvement in their own care and ensure treatment decisions are informed by patient values and preferences. [16][17][18]56 Although this review was partly motivated by a need to identify women's experiences of care, so that this information could be included in shared decision-making consultations to guide mode of birth decisions antenatally, it has highlighted the need for shared decision-making and better communication antenatally, during birth and postnatally. This review highlights that poor communication, where women feel dismissed and not in control of their own birth, is a key issue that contributed to a negative experience.…”

“…[13][14][15] Shared decision-making refers to a process of decision-making that is collaborative between the clinician and patient and considers both the best-available evidence and the patients' values and preferences. [16][17][18][19] The importance of shared decision-making is increasingly reflected in guidelines, stating that the decision for a cesarean should be informed by a process of shared decision-making, involving a discussion around the medical risks and benefits, and what the experience of having a cesarean may be like. [20][21][22] The aim of this review was to gain insight into women's subjective experiences of and satisfaction with cesarean birth, by synthesizing findings from both quantitative research and qualitative research.…”

Safety in surgery: the role of shared decision-making

“…Greater patient involvement in the decision making process led to greater satisfaction with the outcome for these procedures [ 5 ]. Orthopedic elective orthopedic cases such as total joint replacement have also been studied [ 6 - 11 ].…”

‘Motivational work’: a qualitative study of preventive health dialogues in general practice

“…We argue that the approach to motivational work presented in the example resembles a treatmentoriented practice rooted in the biomedical perspective and characterized by an numeric objectification of bodily functions and symptoms based on classification systems for diagnosing somatic and mental diseases, one that rarely included patients' experiences, values, or everyday lives [30,31]. Existing research shows that GPs' focus on diagnoses and treatment affects whether prevention is introduced in the clinical encounter [8,32]. These findings correlate well with the findings in this article.…”