Shared Decision Making in the Medical Encounter: Are We All Talking about the Same Thing?

Moumjid, Nora; Gafni, Amiram; Brémond, A.; Carrère, Marie‐Odile

doi:10.1177/0272989x07306779

Cited by 188 publications

(157 citation statements)

References 60 publications

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“…Terms such as informed consent, informed decision-making, shared decision-making, and patient choice describe situations in which the patient is involved in the decision-making process (Dolan, 2008;Moumjid et al, 2007). Patients' preferences and values are most important in cases where the course of action is uncertain.…”

Section: Shared Decision-makingmentioning

confidence: 99%

Patient involvement and service innovation in healthcare

Engström¹

2014

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This thesis adds to a stream of research suggesting that healthcare can be more patient centered and efficient by redefining the role of the patient from a passive receiver to a more active and collaborative participant. This may relate to healthcare provision (Anderson and Funnell, 2005;Berry and Bendapudi, 2007;Bitner and Brown, 2008;McColl-Kennedy et al., 2012;Nordgren, 2008) and innovation (Bate and Robert, 2006;Groene et al., 2009;Longtin et al., 2010). Through research initiative containing four healthcare units and 68 patients, the present thesis combines healthcare research (e.g., Anderson and Funnell, 2005;Nelson et al., 2002) with service research (e.g., Grönroos, 2006; Lusch, 2008, 2004) to explore three aspects of patient involvement and service innovation.Firstly, the concept of patient involvement itself is investigated through an extensive literature review of empirical research on patient involvement. A model describing the antecedents, forms and consequences of patient involvement is proposed. What value is, and how patients can co-create value is discussed from the perspectives of healthcare research and service management thought.Secondly, the thesis proposes a diary-based methodology for involving patients in service innovation. My colleagues and I developed the methodology in collaboration with the participating care providers and applied it in practice. We used the experiences we gained from the project and the contributions from the patients to examine the opportunities for user involvement in service innovation. The participants contributed with ideas and insights stemming from their experiences in their contact with healthcare and other resources. We suggest the following three ways of learning from the collected data: As ideas for improvements; through summary reports to illustrate other quantitative data; and as narratives to promote change. Thirdly, the thesis explores patients' motivations to participate in service innovation, a hitherto unexplored field. Through an analysis of patients' contributions and interviews with participants we found that there are a number of factors that motivate patients to participate and that participation is perceived as a social-and meaning-laden event. Patients derive psychological well-being and support from participation, but disease was sometimes a barrier to participation. This thesis elaborates on how the most motivated users can be involved in service innovation, applying thinking from the lead-user methodology to a healthcare setting.Overall, the thesis explores patient involvement from new perspectives and, by doing so, adds to our collective efforts to improve healthcare. viii Key words: Patient Involvement, participation, co-creation, patient empowerment, user involvement, patient centered care, motivation, user experiences, co-creation, service development, service innovation, service design, health care, lead users, diary, value ix SAMMANFATTNING Denna avhandling syftar till en mer patientcentrerad och effektiv sjukvård. Den bid...

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Section: Shared Decision-makingmentioning

confidence: 99%

Patient involvement and service innovation in healthcare

Engström¹

2014

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“…10 The term SDM is often used inconsistently. 11,12 The following elements characterize our understanding of SDM [13][14][15][16][17][18] : SDM may (and should) be employed in life-threatening disease, where biomedical factors far outweigh placebo effects in determining the outcome. Nevertheless, physicians frequently encounter treatment decisions involving chronic and self-limited illnesses.…”

Section: Introductionmentioning

confidence: 99%

The Placebo Phenomenon: Implications for the Ethics of Shared Decision-Making

2012

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Recent research into the placebo effect has implications for the ethics of shared decision-making (SDM). The older biomedical model views SDM as affecting which therapy is chosen, but not the nature or likelihood of any health outcomes produced by the therapy. Research indicates, however, that both the content and manner in which information is shared with the patient, and the patient's experience of being involved in the decision, can directly alter therapeutic outcomes via placebo responses. An ethical tension is thereby created between SDM aimed strictly and solely at conveying accurate information, and "outcome engineering" in which SDM is adapted toward therapeutic goals. Several practical strategies mitigate this tension and promote respect for autonomous decision-making while still utilizing the therapeutic potential of SDM.

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“…El término PDC ha sido ampliamente utilizado desde mediados de los 90 aunque el concepto designado no siempre ha sido claro (29). Términos como proceso de decisión informada, proceso de decisión compartida informada, implicación del paciente, cuidado centrado en el paciente, elección del paciente basada en la evidencia o asociación, han sido usados como sinónimos de PDC aunque el significado de los mismos no es idéntico y, en algunos casos, esencialmente distinto.…”

Section: Concepto Y Definiciones De Proceso De Decisión Compartidaunclassified