How option-listing influences decision-making in orthopedic consultations: a conversation analytic study.

Autor: Van der Hout ACA; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, the Netherlands., Huiskes M; Center for Language and Cognition, University of Groningen, Groningen, the Netherlands., Gosens T; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, the Netherlands; Department of Orthopedics, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands., Den Oudsten BL; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, the Netherlands. Electronic address: b.l.denoudsten@tilburguniversity.edu.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2025 Jan; Vol. 130, pp. 108450. Date of Electronic Publication: 2024 Sep 21.
DOI: 10.1016/j.pec.2024.108450
Abstrakt: Objectives: Examine which practices orthopedists use to do option-listing, a technique that can facilitate shared decision-making (SDM).
Methods: A conversation analytic study of 35 orthopedic consultations with newly referred patients with hip and/or knee osteoarthritis.
Results: Orthopedists implement option-listing in consultations using two organizational principles: 1) A fixed order of options that constitutes a scale (based on the severity of treatment). Presenting this scale (in two possible orders) encodes this fixed order; 2) Options are presented in relation to each other, rather than as individual options to be discussed incrementally. This format provides orthopedists with interactional slots to formulate their professional stance by presenting options as considered but rejected. Patients co-construct this list by taking a recipient role and not responding to the individual items of the list.
Conclusions: Option-listing can facilitate SDM, allowing patients to choose amongst options. A drawback is that, while the organizational principles of option-listing allow orthopedists to express a professional opinion, they also place patients in an interactional position in which they have to address the orthopedists' epistemic stance. On the other hand, patients can use the scale to propose their own preferences.
Practical Implications: Awareness of the interactional consequences of option-listing might optimize SDM.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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