Article type
Year
Abstract
Background: shared decision-making (SDM) is patient-centred, patient-physician communication for clinical decision-making to improve the quality of care. As the world population ages, lumbar degenerative diseases (LDD) have become the most prevalent and the largest contributor to the burden of disability; the various treatment options include medication, physical therapy, and surgery. The key to successful treatment is good communication between the patient and the physician, as well as collaboration between them to choose the most appropriate and practical treatment option based on the patients’ preferences and values. However, there is a lack of research on the decision antecedents and outcomes of SDM in patients with LDD.
Objectives: to examine the decision antecedents on SDM process and explore the impact of SDM processes on the decision outcomes among patients with LDD.
Methods: this cross-sectional study adopted the theoretical framework of SDM proposed by Sepucha and Mulley in 2009 and used a continuous sampling method to administer the questionnaire survey in adult outpatients with LDD in two teaching hospitals of the Taipei Medical University. Multiple linear regressions were used to assess the associations between the decision antecedents including Control Preference Scale (CPS), Decision Self-Efficacy Scale (DSES), Preparation for Decision Making scale (PrepDM), and decision-making process of 9-item SDM Questionnaire (SDM-Q-9) after controlling for relevant personal factors. Simple linear regressions were used to assess the relationships between SDM-Q-9 and decision outcomes such as Decisional Conflict Scale (DCS) and the Satisfaction with Decision Instrument (SWD).
Results: a total of 113 patients with a mean age of 61.4 years enrolled in the study. Age and educational levels are two personal factors significantly related with the degree of the SDM process. Our results showed that DSES and PrepDM significantly predicted SDM-Q-9 (p < 0.001) after adjusting for personal factors. The SDM-Q-9 also had significant (p < 0.001) influences on both DCS and SWD.
Conclusions: our results revealed that readiness for SDM is a significant antecedent for patients’ involvement in the SDM process. In addition, the SDM process is positively associated with satisfaction in SDM and negatively related to the decisional conflict.
Patient or healthcare consumer involvement: understanding the antecedent and outcomes of the SDM framework could help clinicians target high-risk populations and tailor SDM strategies to improve involvement in the SDM process and promote the quality of healthcare outcomes for patients with LDD. Further advocating for patients' health literacy in SDM and facilitating healthcare providers' SDM communication are requisites especially for patients with low self-efficacy and insufficient preparation for SDM to improve satisfaction and mitigate decisional conflicts.
Objectives: to examine the decision antecedents on SDM process and explore the impact of SDM processes on the decision outcomes among patients with LDD.
Methods: this cross-sectional study adopted the theoretical framework of SDM proposed by Sepucha and Mulley in 2009 and used a continuous sampling method to administer the questionnaire survey in adult outpatients with LDD in two teaching hospitals of the Taipei Medical University. Multiple linear regressions were used to assess the associations between the decision antecedents including Control Preference Scale (CPS), Decision Self-Efficacy Scale (DSES), Preparation for Decision Making scale (PrepDM), and decision-making process of 9-item SDM Questionnaire (SDM-Q-9) after controlling for relevant personal factors. Simple linear regressions were used to assess the relationships between SDM-Q-9 and decision outcomes such as Decisional Conflict Scale (DCS) and the Satisfaction with Decision Instrument (SWD).
Results: a total of 113 patients with a mean age of 61.4 years enrolled in the study. Age and educational levels are two personal factors significantly related with the degree of the SDM process. Our results showed that DSES and PrepDM significantly predicted SDM-Q-9 (p < 0.001) after adjusting for personal factors. The SDM-Q-9 also had significant (p < 0.001) influences on both DCS and SWD.
Conclusions: our results revealed that readiness for SDM is a significant antecedent for patients’ involvement in the SDM process. In addition, the SDM process is positively associated with satisfaction in SDM and negatively related to the decisional conflict.
Patient or healthcare consumer involvement: understanding the antecedent and outcomes of the SDM framework could help clinicians target high-risk populations and tailor SDM strategies to improve involvement in the SDM process and promote the quality of healthcare outcomes for patients with LDD. Further advocating for patients' health literacy in SDM and facilitating healthcare providers' SDM communication are requisites especially for patients with low self-efficacy and insufficient preparation for SDM to improve satisfaction and mitigate decisional conflicts.