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Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research

BACKGROUND: Shared decision making (SDM) is generally treated as good practice in health‐care interactions. Conversation analytic research has yielded detailed findings about decision making in health‐care encounters. OBJECTIVE: To map decision making communication practices relevant to health‐care...

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Autores principales: Land, Victoria, Parry, Ruth, Seymour, Jane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690232/
https://www.ncbi.nlm.nih.gov/pubmed/28520201
http://dx.doi.org/10.1111/hex.12557
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author Land, Victoria
Parry, Ruth
Seymour, Jane
author_facet Land, Victoria
Parry, Ruth
Seymour, Jane
author_sort Land, Victoria
collection PubMed
description BACKGROUND: Shared decision making (SDM) is generally treated as good practice in health‐care interactions. Conversation analytic research has yielded detailed findings about decision making in health‐care encounters. OBJECTIVE: To map decision making communication practices relevant to health‐care outcomes in face‐to‐face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM. SEARCH STRATEGY: We searched nine electronic databases (last search November 2016) and our own and other academics' collections. INCLUSION CRITERIA: Published conversation analyses (no restriction on publication dates) using recordings of health‐care encounters in English where the patient (and/or companion) was present and where the data and analysis focused on health/illness‐related decision making. DATA EXTRACTION AND SYNTHESIS: We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively. RESULTS: Twenty‐eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organized these in relation to four elements of decision‐making sequences: (i) broaching decision making; (ii) putting forward a course of action; (iii) committing or not (to the action put forward); and (iv) HCPs' responses to patients' resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs' practices may constrain or encourage this participation. CONCLUSIONS: Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non‐negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (eg by bringing the patient towards shared understanding of the decision's rationale).
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spelling pubmed-56902322017-12-01 Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research Land, Victoria Parry, Ruth Seymour, Jane Health Expect Review Articles BACKGROUND: Shared decision making (SDM) is generally treated as good practice in health‐care interactions. Conversation analytic research has yielded detailed findings about decision making in health‐care encounters. OBJECTIVE: To map decision making communication practices relevant to health‐care outcomes in face‐to‐face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM. SEARCH STRATEGY: We searched nine electronic databases (last search November 2016) and our own and other academics' collections. INCLUSION CRITERIA: Published conversation analyses (no restriction on publication dates) using recordings of health‐care encounters in English where the patient (and/or companion) was present and where the data and analysis focused on health/illness‐related decision making. DATA EXTRACTION AND SYNTHESIS: We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively. RESULTS: Twenty‐eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organized these in relation to four elements of decision‐making sequences: (i) broaching decision making; (ii) putting forward a course of action; (iii) committing or not (to the action put forward); and (iv) HCPs' responses to patients' resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs' practices may constrain or encourage this participation. CONCLUSIONS: Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non‐negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (eg by bringing the patient towards shared understanding of the decision's rationale). John Wiley and Sons Inc. 2017-05-18 2017-12 /pmc/articles/PMC5690232/ /pubmed/28520201 http://dx.doi.org/10.1111/hex.12557 Text en © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Articles
Land, Victoria
Parry, Ruth
Seymour, Jane
Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research
title Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research
title_full Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research
title_fullStr Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research
title_full_unstemmed Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research
title_short Communication practices that encourage and constrain shared decision making in health‐care encounters: Systematic review of conversation analytic research
title_sort communication practices that encourage and constrain shared decision making in health‐care encounters: systematic review of conversation analytic research
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690232/
https://www.ncbi.nlm.nih.gov/pubmed/28520201
http://dx.doi.org/10.1111/hex.12557
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