Factors associated with level of shared decision making in Malaysian primary care consultations.

Autor: Lee YK; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: leeyk@um.edu.my., Chor YY; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia., Tan MY; School of Medicine, University of Glasgow, Glasgow, UK., Ngio YC; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia., Chew AW; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia., Tiew HW; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia., Syahirah MR; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia., Ng CJ; Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2020 May; Vol. 103 (5), pp. 1049-1051. Date of Electronic Publication: 2019 Dec 10.
DOI: 10.1016/j.pec.2019.12.005
Abstrakt: Objective: To measure the level of shared decision-making (SDM) in primary care consultations in Malaysia, a multicultural, middle-income developing country.
Methods: A cross-sectional study was conducted in an urban, public primary care clinic. Convenience sampling was used to recruit participants, and audio-recorded consultations were scored for SDM levels by two independent raters using the OPTION tool. Univariate and multivariate analysis was conducted to determine factors significantly associated with SDM levels.
Results: 199 patients and 31 doctors participated. Mean consultation time was 14.3 min (+ SD 5.75). Patients' age ranged from 18 to 87 years (median age of 57.5 years). 52.8 % of patients were female, with three main ethnicities (Malay, Chinese, Indian). The mean OPTION score was found to be 7.8 (+ SD 3.31) out of 48. After a multivariate analysis, only patient ethnicity (β= -0.142, p < 0.05) and increased consultation time (β = 0.407, p < 0.01) were associated with higher OPTION scores.
Conclusions: Patients in Malaysia experience extremely poor levels of SDM in general practice. Higher scores were associated with increased consultation time and patient ethnicity.
Practice Implications: Malaysian general practitioners should aim to develop and practice cultural competency skills to avoid biased SDM practice towards certain ethnicities.
Competing Interests: Declaration of Competing Interest There are no conflicts of interest to declare. The study was self-funded.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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