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Shared decision-making in cardiology: do patients want it and do doctors provide it?

Burton, David, Blundell, Nicholas, Jones, Mari, Fraser, Alan Gordon and Elwyn, Glyn 2010. Shared decision-making in cardiology: do patients want it and do doctors provide it? Patient Education and Counseling 80 (2) , pp. 173-179. 10.1016/j.pec.2009.10.013

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Objective Doctors should involve their patients in makingdecisions about their care. We studied patients with heart disease to assess if shareddecision-making occurs and to study factors that predict patients’ choices or influence cardiologists’ behaviour. Methods 85 patients attending for arteriography were assessed to elicit preferred involvement in decision-making, perception of involvement, and confidence in the decision. Results 40% of patients wished to be involved in decisions. Preferences were unrelated to demographic factors. Cardiologists involved patients more in decisions concerning severe disease (p = 0.056). Involvement varied between cardiologists (p = 0.001). The mean duration of consultations was 5.5 min. Patients’ confidence in decisions correlated with duration (p = 0.001), explicit reference to a decision that needed to be made (p = 0.0026), and perceived, but not observed, involvement in decision-making (p = 0.05). Conclusion This study highlighted the complexity of doctor–patient communication. Irrespective of preferences for involvement, patients were more confident in decisions in which they perceived more involvement or which were the products of longer consultations. Practice implications Patients’ confidence in clinical decisions can be increased by increasing consultation length and increasing their perception of involvement. Patients perceive more involvement in decisions when doctors specifically identify the need for treatment decisions early in the consultation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Mathematics
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Decision-making; Autonomy; Cardiology
Publisher: Elsevier
ISSN: 0738-3991
Last Modified: 04 Jun 2017 03:48

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