Completing the third person's perspective on patients’ involvement in medical decision-making: approaching the full picture
Abstract
Objective Shared decision making is based on the idea of cooperation and partnership between patients and doctors. In this concept both parties may initiate and perform specific decision-making steps. However, the common observation-based instruments focus solely on doctors' behaviour. Content and quality of information provided to involve patients in medical decisions are hardly considered in evaluation of SDM. This study investigates the advantages of a revised observer inventory taking into account these aspects.Methods Based on the OPTION scale, a more comprehensive observation-based inventory was developed, additionally considering both the patient-sided indicators for patient involvement and the criteria of evidence-based patient information. The inventory comprises three scales (doctor, patient, doctor-patient dyad) and 15 indicators each. Rater training and re-analyses of 76 consultations previously analysed using the OPTION scale were conducted. Convergent validities were calculated between the observer-based scales and the patients' ratings on the Shared Decision Making Questionnaire, the Decisional Conflict Scale and the Control Preference Scale.Results Interrater reliabilities of the revised scales were high (r=.87 to .74) and even higher when only the dyadic perspective was coded (.86). The revised inventory provided additional information on the involvement taking place. No substantive correlations were found between observation-based and patients' subjective judgments.Conclusion The observers' perspective on patient involvement needs to consider patient activities. Inconsistencies of patients' and observers' judgements concerning patient participation need further investigation.
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Six existing decision aids about location of care for the elderly were found, but they were excluded because they targeted specific populations or did not fulfill all IPDAS minimal criteria.
“We found six existing DAs about location of care for the elderly [20–22, 27]. However, these were excluded as they targeted specific populations (e.g., veterans, elderly people with dementia, caregivers only), or did not fulfill all IPDAS minimal criteria.”
From Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design (2016) · cites this paper as [27]
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Self-citation
- Authors
- Kasper, J., Hoffmann, F., Heesen, C., Köpke, S., & Geiger, F.
- Affiliations
- Universität Hamburg (DE)
- University Hospital Schleswig-Holstein (DE)
- Corresponding author
- Kasper, Jürgen
- Venue
- Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 106
- Issue
- 4
- Pages
- 275-283
- ISSN
- 1865-9217 (ISSN-L)
- OpenAlex
- W2070190131
- Cited by
- 25
- References
- 45
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2022: 1 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 3.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Biogen
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- shared decision-making, patient involvement, patient information quality, evidence-based patient information, inter-rater reliability, convergent validity, Decisional Conflict Scale, Control Preferences Scale
- MeSH terms
- Conflict, Psychological, Cooperative Behavior, Decision Making, Humans, Patient Participation, Physician-Patient Relations, Psychometrics, Surveys and Questionnaires, Reproducibility of Results, Program Evaluation, Observer Variation
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