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Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
OBJECTIVES: Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient prefer...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030606/ https://www.ncbi.nlm.nih.gov/pubmed/27638491 http://dx.doi.org/10.1136/bmjopen-2016-011282 |
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author | Hamann, Johannes Kissling, Werner Mendel, Rosmarie |
author_facet | Hamann, Johannes Kissling, Werner Mendel, Rosmarie |
author_sort | Hamann, Johannes |
collection | PubMed |
description | OBJECTIVES: Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient preferences. Within the present study we wanted to evaluate at what time in the decision-making process a doctor's recommendation is best given, not to adversely influence patient preferences. DESIGN: We performed an experimental study involving hypothetical decisions vignettes and compared the influence of 3 conditions (no advice, early advice, late advice) on patients' decision-making. SETTING: N=21 psychiatric hospitals in Germany. PARTICIPANTS: N=208 inpatients suffering from schizophrenia. PRIMARY AND SECONDARY OUTCOME MEASURES: The main outcome was the number of patients choosing the option in each experimental condition that had been less preferable to most patients during pretests. Additional outcome measures were patient satisfaction and reactance. RESULTS: Patients in the ‘late advice’ condition more often (n=49) accepted an advice that was against their preferences compared with the other conditions (n=36 for ‘early advice’, p=0.024). CONCLUSIONS: Although giving advice is an important part of every doctor's daily practice and is seen as an essential element of shared decision-making, hitherto there has been little empirical evidence relating to the influence of physicians' advice on patients' decision-making behaviour. With our study we could show that the point in time an advice is given by a physician does have an influence on patients' decisional behaviour even if the mechanism of this effect is not yet understood. |
format | Online Article Text |
id | pubmed-5030606 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-50306062016-10-04 Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia Hamann, Johannes Kissling, Werner Mendel, Rosmarie BMJ Open Patient-Centred Medicine OBJECTIVES: Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient preferences. Within the present study we wanted to evaluate at what time in the decision-making process a doctor's recommendation is best given, not to adversely influence patient preferences. DESIGN: We performed an experimental study involving hypothetical decisions vignettes and compared the influence of 3 conditions (no advice, early advice, late advice) on patients' decision-making. SETTING: N=21 psychiatric hospitals in Germany. PARTICIPANTS: N=208 inpatients suffering from schizophrenia. PRIMARY AND SECONDARY OUTCOME MEASURES: The main outcome was the number of patients choosing the option in each experimental condition that had been less preferable to most patients during pretests. Additional outcome measures were patient satisfaction and reactance. RESULTS: Patients in the ‘late advice’ condition more often (n=49) accepted an advice that was against their preferences compared with the other conditions (n=36 for ‘early advice’, p=0.024). CONCLUSIONS: Although giving advice is an important part of every doctor's daily practice and is seen as an essential element of shared decision-making, hitherto there has been little empirical evidence relating to the influence of physicians' advice on patients' decision-making behaviour. With our study we could show that the point in time an advice is given by a physician does have an influence on patients' decisional behaviour even if the mechanism of this effect is not yet understood. BMJ Publishing Group 2016-09-16 /pmc/articles/PMC5030606/ /pubmed/27638491 http://dx.doi.org/10.1136/bmjopen-2016-011282 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Patient-Centred Medicine Hamann, Johannes Kissling, Werner Mendel, Rosmarie Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia |
title | Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia |
title_full | Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia |
title_fullStr | Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia |
title_full_unstemmed | Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia |
title_short | Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia |
title_sort | does it matter whether physicians' recommendations are given early or late in the decision-making process? an experimental study among patients with schizophrenia |
topic | Patient-Centred Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030606/ https://www.ncbi.nlm.nih.gov/pubmed/27638491 http://dx.doi.org/10.1136/bmjopen-2016-011282 |
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