Reflecting on shared decision making: A reflection‐quantification study

Autor: Marleen Kunneman, Christina M. LaVecchia, Naykky Singh Ospina, Abd Moain Abu Dabrh, Emma M. Behnken, Patrick Wilson, Megan E. Branda, Ian G. Hargraves, Kathleen J. Yost, Richard M. Frankel, Victor M. Montori
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Health Expectations, Vol 22, Iss 5, Pp 1165-1172 (2019)
Druh dokumentu: article
ISSN: 1369-7625
1369-6513
DOI: 10.1111/hex.12953
Popis: Abstract Background Reflecting (“stop‐and‐think”) before rating may help patients consider the quality of shared decision making (SDM) and mitigate ceiling/halo effects that limit the performance of self‐reported SDM measures. Methods We asked a diverse patient sample from the United States to reflect on their care before completing the 3‐item CollaboRATE SDM measure. Study 1 focused on rephrasing CollaboRATE items to promote reflection before each item. Study 2 used 5 open‐ended questions (about what went well and what could be improved upon, signs that the clinician understood the patient's situation, how the situation will be addressed, and why this treatment plan makes sense) to invite reflection before using the whole scale. A linear analogue scale assessed the extent to which the plan of care made sense to the patient. Results In Study 1, 107 participants completed surveys (84% response rate), 43 (40%) rated a clinical decision of which 27 (63%) after responding to reflection questions. Adding reflection lowered CollaboRATE scores (“less” SDM) and reduced the proportion of patients giving maximum (ceiling) scores (not statistically significant). In Study 2, 103 of 212 responders (49%) fully completed the version containing reflection questions. Reflection did not significantly change the distribution of CollaboRATE scores or of top scores. Participants indicated high scores on the sense of their care plan (mean 9.7 out of 10, SD 0.79). This rating was weakly correlated with total CollaboRATE scores (rho = .4, P = .0001). Conclusion Reflection‐before‐quantification interventions may not improve the performance of patient‐reported measures of SDM with substantial ceiling/halo effects.
Databáze: Directory of Open Access Journals
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