Shared Decision Making in Vascular Surgery: An Exploratory Study.

Autor: Santema TB; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: t.b.santema@amc.uva.nl., Stubenrouch FE; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands., Koelemay MJ; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands., Vahl AC; Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Vermeulen CF; Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands., Visser MJ; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Ubbink DT; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery [Eur J Vasc Endovasc Surg] 2016 Apr; Vol. 51 (4), pp. 587-93. Date of Electronic Publication: 2016 Feb 01.
DOI: 10.1016/j.ejvs.2015.12.010
Abstrakt: Objectives: Shared decision making (SDM) is a process in which patients and their doctors collaborate in choosing a suitable treatment option by incorporating patient values and preferences, as well as the best available evidence. Particularly in vascular surgery, several conditions seem suitable for SDM because there are multiple treatment options. The objective of this study was to assess the degree of SDM behaviour in vascular surgery.
Methods: Vascular surgeons of four Dutch hospitals selected consultations with patients who were facing a treatment decision. Immediately after the consultation, patients and surgeons completed the (subjective) SDM Q-9 and SDM Q-doc questionnaires respectively, to appreciate the perceived level of SDM behaviour. Two evaluators independently and objectively rated SDM behaviour in the audiotaped consultations, using the Observing Patient Involvement (OPTION-12) scale.
Results: Nine vascular surgeons and three vascular surgeons in training conducted 54 consultations. The patients' median SDM Q-9 score was high, 93% (IQR 79-100%), and 16/54 (29.6%) of them gave the maximum score. The surgeons' median score was also high, 84% (IQR 73-92%), while 4/54 (7.4%) gave the maximum score. In contrast, mean OPTION score was 31% (SD 11%). Surgeons hardly ever asked the patients for their preferred approach to receive information, whether they had understood the provided information, and how they would like to be involved in SDM.
Conclusions: Currently, objective SDM behaviour among vascular surgeons is limited, even though the presented disorders allow for SDM. Hence, SDM in vascular surgical consultations could be improved by increasing the patients' and surgeons' awareness and knowledge about the concept of SDM.
(Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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