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dc.date.accessioned2019-01-23T16:22:43Z
dc.date.available2019-10-26T22:46:05Z
dc.date.created2018-11-30T08:51:30Z
dc.date.issued2017
dc.identifier.citationLee, Joy Callon, Wynne Haywood Jr, Carlton Lanzkron, Sophie M Gulbrandsen, Pål Beach, Mary Catherine . What does shared decision making look like in natural settings? A mixed methods study of patient-provider conversations. Communication & Medicine. An Interdisciplinary Journal of Healthcare, Ethics and Society. 2017, 14(3), 217-228
dc.identifier.urihttp://hdl.handle.net/10852/66305
dc.description.abstractObjective: To understand the variability and nature of shared decision making (SDM) regarding a uniform type of serious medical decision, and to make normative judgments about how these conversations might be improved. Methods: This was a mixed-methods sub-analysis of the Improving Patient Outcomes with Respect and Trust (IMPORT) Study. We used the Braddock framework to identify and describe seven elements of SDM in audio-recorded encounters regarding initiation of hydroxyurea, and used data from medical records and patient questionnaires to understand whether and how these tasks were achieved. Results: Physicians covered a spectrum of SDM behaviors: all dialogues contained discussion regarding the clinical issue and the pros and cons of treatment; the patient’s understanding and role were not explicitly assessed or stated in any encounter. Yet no patient agreed to start hydroxyurea who did not already prefer it. There was no uniform approach to how physicians presented risk; many concerns expressed by patients in a pre-visit questionnaire were not discussed. Conclusion: In this analysis, patients seemed to understand their role in the decision-making process, suggesting that a patient’s role may not always need to be explicitly stated. However, shared decision making might be improved with more routine assessment of patient understanding and concerns. Standardized decision aids might help fully inform patients of risks and benefits.en_US
dc.languageEN
dc.publisherVerlag de Gruyter
dc.titleWhat does shared decision making look like in natural settings? A mixed methods study of patient-provider conversationsen_US
dc.typeJournal articleen_US
dc.creator.authorLee, Joy
dc.creator.authorCallon, Wynne
dc.creator.authorHaywood Jr, Carlton
dc.creator.authorLanzkron, Sophie M
dc.creator.authorGulbrandsen, Pål
dc.creator.authorBeach, Mary Catherine
cristin.unitcode185,53,84,0
cristin.unitnameKlinikk for helsetjenesteforskning og psykiatri
cristin.ispublishedtrue
cristin.fulltextpostprint
cristin.qualitycode1
dc.identifier.cristin1637262
dc.identifier.bibliographiccitationinfo:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Communication & Medicine. An Interdisciplinary Journal of Healthcare, Ethics and Society&rft.volume=14&rft.spage=217&rft.date=2017
dc.identifier.jtitleCommunication & Medicine. An Interdisciplinary Journal of Healthcare, Ethics and Society
dc.identifier.volume14
dc.identifier.issue3
dc.identifier.startpage217
dc.identifier.endpage228
dc.identifier.doi10.1558/cam.32815
dc.identifier.urnURN:NBN:no-69510
dc.type.documentTidsskriftartikkelen_US
dc.type.peerreviewedPeer reviewed
dc.source.issn1612-1783
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/66305/4/Lee%2BCommun%2BMed%2B2018%2Bpostprint.pdf
dc.type.versionAcceptedVersion


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