دورية أكاديمية
أعرض في EDS

Problem-based shared decision-making in diabetes care: a secondary analysis of video-recorded encounters.

التفاصيل البيبلوغرافية
العنوان: Problem-based shared decision-making in diabetes care: a secondary analysis of video-recorded encounters.
المؤلفون: Ruissen MM; Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands.; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA., Montori VM; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA., Hargraves IG; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA., Branda ME; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA.; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA., León García M; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA.; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain., de Koning EJ; Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands., Kunneman M; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA kunneman@lumc.nl.; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
المصدر: BMJ evidence-based medicine [BMJ Evid Based Med] 2023 Jun; Vol. 28 (3), pp. 157-163. Date of Electronic Publication: 2023 Mar 02.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101719009 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2515-4478 (Electronic) Linking ISSN: 2515446X NLM ISO Abbreviation: BMJ Evid Based Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group, [2018]-
مواضيع طبية MeSH: Diabetes Mellitus, Type 2*/therapy, Humans ; Decision Making, Shared ; Communication ; Patient Participation ; Research Design
مستخلص: Objectives: To describe the range of collaborative approaches to shared decision-making (SDM) observed in clinical encounters of patients with diabetes and their clinicians.
Design: A secondary analysis of videorecordings obtained in a randomised trial comparing usual diabetes primary care with or without using a within-encounter conversation SDM tool.
Setting: Using the purposeful SDM framework, we classified the forms of SDM observed in a random sample of 100 video-recorded clinical encounters of patients with type 2 diabetes in primary care.
Main Outcome Measures: We assessed the correlation between the extent to which each form of SDM was used and patient involvement (OPTION12-scale).
Results: We observed at least one instance of SDM in 86 of 100 encounters. In 31 (36%) of these 86 encounters, we found only one form of SDM, in 25 (29%) two forms, and in 30 (35%), we found ≥3 forms of SDM. In these encounters, 196 instances of SDM were identified, with weighing alternatives (n=64 of 196, 33%), negotiating conflicting desires (n=59, 30%) and problemsolving (n=70, 36%) being similarly prevalent and developing existential insight accounting for only 1% (n=3) of instances. Only the form of SDM focused on weighing alternatives was correlated with a higher OPTION12-score. More forms of SDM were used when medications were changed (2.4 SDM forms (SD 1.48) vs 1.8 (SD 1.46); p=0.050).
Conclusions: After considering forms of SDM beyond weighing alternatives, SDM was present in most encounters. Clinicians and patients often used different forms of SDM within the same encounter. Recognising a range of SDM forms that clinicians and patients use to respond to problematic situations, as demonstrated in this study, opens new lines of research, education and practice that may advance patient-centred, evidence-based care.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: Diabetes Mellitus
تواريخ الأحداث: Date Created: 20230303 Date Completed: 20230524 Latest Revision: 20230704
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10314025
DOI: 10.1136/bmjebm-2022-112067
PMID: 36868578
قاعدة البيانات: MEDLINE
الوصف
تدمد:2515-4478
DOI:10.1136/bmjebm-2022-112067