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Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom

Applying both theoretical perspectives and empirical evidence, we address 2 key questions regarding shared decision making (SDM): 1) When should SDM be more patient driven, and when should it be more provider driven? and 2) Should health care providers match their SDM style/strategy to patient needs...

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Autores principales: Resnicow, Ken, Catley, Delwyn, Goggin, Kathy, Hawley, Sarah, Williams, Geoffrey C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108118/
https://www.ncbi.nlm.nih.gov/pubmed/34784805
http://dx.doi.org/10.1177/0272989X211058068
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author Resnicow, Ken
Catley, Delwyn
Goggin, Kathy
Hawley, Sarah
Williams, Geoffrey C.
author_facet Resnicow, Ken
Catley, Delwyn
Goggin, Kathy
Hawley, Sarah
Williams, Geoffrey C.
author_sort Resnicow, Ken
collection PubMed
description Applying both theoretical perspectives and empirical evidence, we address 2 key questions regarding shared decision making (SDM): 1) When should SDM be more patient driven, and when should it be more provider driven? and 2) Should health care providers match their SDM style/strategy to patient needs and preferences? Self-determination theory, for example, posits a distinction between autonomy and independence. A patient may autonomously seek their health care provider’s input and guidance, perhaps due to low perceived competence, low coping resources, or high emotional arousal. Given their need state, they may autonomously require nonindependence. In this case, it may be more patient centered and need supportive to provide more provider-driven care. We discuss how other patient characteristics such as personality attributes, motivational state, and the course of illness and other parameters such as time available for an encounter may inform optimal provider decision-making style and strategy. We conclude that for some types of patients and clinical circumstances, a more provider-driven approach to decision making may be more practical, ethical, and efficacious. Thus, while all decision making should be patient centered (i.e., it should consider patient needs and preferences), it does not always have to be patient driven. We propose a flexible model of SDM whereby practitioners are encouraged to tailor their decision making behaviors to patient needs, preferences, and other attributes. Studies are needed to test whether matching decision-making behavior based on patient states and traits (i.e., achieving concordance) is more effective than simply providing all patients with the same type of decision making, which could be tested using matching/mismatching designs.
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spelling pubmed-91081182022-07-14 Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom Resnicow, Ken Catley, Delwyn Goggin, Kathy Hawley, Sarah Williams, Geoffrey C. Med Decis Making Special Section on Theories of Medical Decision Making Applying both theoretical perspectives and empirical evidence, we address 2 key questions regarding shared decision making (SDM): 1) When should SDM be more patient driven, and when should it be more provider driven? and 2) Should health care providers match their SDM style/strategy to patient needs and preferences? Self-determination theory, for example, posits a distinction between autonomy and independence. A patient may autonomously seek their health care provider’s input and guidance, perhaps due to low perceived competence, low coping resources, or high emotional arousal. Given their need state, they may autonomously require nonindependence. In this case, it may be more patient centered and need supportive to provide more provider-driven care. We discuss how other patient characteristics such as personality attributes, motivational state, and the course of illness and other parameters such as time available for an encounter may inform optimal provider decision-making style and strategy. We conclude that for some types of patients and clinical circumstances, a more provider-driven approach to decision making may be more practical, ethical, and efficacious. Thus, while all decision making should be patient centered (i.e., it should consider patient needs and preferences), it does not always have to be patient driven. We propose a flexible model of SDM whereby practitioners are encouraged to tailor their decision making behaviors to patient needs, preferences, and other attributes. Studies are needed to test whether matching decision-making behavior based on patient states and traits (i.e., achieving concordance) is more effective than simply providing all patients with the same type of decision making, which could be tested using matching/mismatching designs. SAGE Publications 2021-11-16 2022-08 /pmc/articles/PMC9108118/ /pubmed/34784805 http://dx.doi.org/10.1177/0272989X211058068 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Special Section on Theories of Medical Decision Making
Resnicow, Ken
Catley, Delwyn
Goggin, Kathy
Hawley, Sarah
Williams, Geoffrey C.
Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom
title Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom
title_full Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom
title_fullStr Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom
title_full_unstemmed Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom
title_short Shared Decision Making in Health Care: Theoretical Perspectives for Why It Works and For Whom
title_sort shared decision making in health care: theoretical perspectives for why it works and for whom
topic Special Section on Theories of Medical Decision Making
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108118/
https://www.ncbi.nlm.nih.gov/pubmed/34784805
http://dx.doi.org/10.1177/0272989X211058068
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