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What are the external influences on information exchange and shared decision-making in healthcare consultations: a meta-synthesis of the literature

Edwards, Michelle, Davies, Myfanwy Mair and Edwards, Adrian G. 2009. What are the external influences on information exchange and shared decision-making in healthcare consultations: a meta-synthesis of the literature. Patient Education and Counseling 75 (1) , pp. 37-52. 10.1016/j.pec.2008.09.025

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Objective To review the literature to identify externalinfluences on informationexchange and shareddecision-making in healthcare consultations and conceptualise how information is used both outside and within a consultation. Methods A ‘meta-study’ approach (meta-data-analysis, meta-theory, meta-method, and meta-synthesis) was used to locate, review, synthesise and summarise the findings, methodology, theoretical orientation and interpretation of qualitative research papers. Results In a model of externalinfluences on informationexchange within healthcare consultations, practitioner influences were: receptiveness to informed patients and patient choice, lack of knowledge of cultural difference, patient centredness vs. stereotyping. Patient influences were: motivation to seek and engage with information; the appraisal of information before a consultation, expression of cultural identity, and ways of managing the risk of poor information. Sharedinfluences were: differing illness notions, role expectations and language. Empowerment, disempowerment and non-empowerment were outcomes of informationexchange and health literacy was a mediator of externalinfluences and empowerment. Conclusion This meta-study provides a conceptualisation of externalinfluences on informationexchange in shareddecision-making where health literacy mediates patient related influences and is also an influence on empowerment. Practice implications Our model can inform the development of interventions aimed at improving informationexchange and shareddecision-making, potentially contributing to more equitable healthcare encounters.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Informationexchange; Externalinfluences; Shareddecision-making; Health literacy; Empowerment
Publisher: Elsevier
ISSN: 0738-3991
Last Modified: 10 Oct 2017 14:14

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