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Grilo AM, Vinagre G, dos Santos MC, Martinho JF, Gomes AI. Attitudes toward Patient-Centred Care, Empathy, and Assertiveness among Students in Rehabilitation Areas: A Longitudinal Study. Healthcare (Basel) 2023; 11:2803. [PMID: 37893877 PMCID: PMC10606137 DOI: 10.3390/healthcare11202803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
This study assessed attitudes toward patient-centred care, empathy, assertiveness, and subjective perception of communication skills and technical knowledge among Portuguese undergraduate students in healthcare. These students may develop rehabilitation activities with patients in their person-oriented or technique-oriented professions. Portuguese nursing and allied health students from two public higher education schools completed questionnaires in the first and third academic years: Patient-Practitioner Orientation Scale, Jefferson Scale of Physician Empathy, Scale for Interpersonal Behaviour, and a subjective perception of technical knowledge and communication skills. A total of 183 students completed the surveys. In the first year, students showed moderate to high scores on patient-centredness attitudes, empathy, and assertiveness and perceived themselves as having good communication skills. Students from person-oriented programmes significantly improved their Total and shared patient-centred attitudes in the third year compared with students attending technique-oriented professions. Significant differences in empathy were found between groups in the third year. Distress associated with assertive behaviours increased significantly across time in students from technique-oriented programmes compared with their peers in person-oriented programmes. The results suggest that the health profession's orientation and the programmes' specific curriculum might have a role in how some dimensions evolved in the two groups of students. The increasing assertiveness-related discomfort highlighted the importance of assessing and monitoring students' emotional wellbeing during their initial interactions with patients.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC—Health & Technology Research Center, Escola Superior de Tecnologia da Saúde, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
| | - Graça Vinagre
- Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1990-096 Lisboa, Portugal;
| | - Margarida Custódio dos Santos
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
- Escola Superior de Tecnologia da Saúde, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Joana Ferreira Martinho
- Câmara Municipal de Oliveira do Bairro, Ed. Paços do Concelho, Praça do Município, 3770-851 Oliveira do Bairro, Portugal;
| | - Ana Isabel Gomes
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
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Yang C, Feng X, Li J, Jiang Y, Zhang H, Gao Y, Tan J, Ran B. Clinical Knowledge, Perceptions, and Communication Confidence Regarding the Development of Thyroid Cancer --A Cross-Sectional Study of Clinical Medical Students in Chongqing, Southwest China. Risk Manag Healthc Policy 2023; 16:2101-2111. [PMID: 37849656 PMCID: PMC10577241 DOI: 10.2147/rmhp.s424052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023] Open
Abstract
Purpose Medical students play an essential role in providing disease consultation for patients. Despite the rapid increase in thyroid disease, there are few data on how well Chinese medical students master the knowledge of thyroid diseases. This study aims to evaluate the clinical knowledge, perception, and clinical communication confidence of medical students on thyroid cancer (TC). Patients and Methods This cross-sectional study was carried out among medical students of Chongqing Medical University. An anonymous, self-administered questionnaire distributed from December 2022 to February 2023 included items on demographics and other information, the warning signs of cancer, perception regarding a person's chance of developing cancer, and clinical communication confidence. Descriptive analysis, difference analysis, and correlation analysis were carried out. Results A total of 226 medical students participated in the survey. Most students (n=191, 84.5%) had heard of TC, while only a few (n=10, 4.4%) regularly performed thyroid self-examination. One hundred and eighty-four students (81.4%) agreed that an unexplained lump or swelling could be a sign of cancer. There were significant differences in thyroid clinical knowledge in relation to gender (P<0.001), major (P=0.026), and thyroid disease (P=0.030). Clinical communication confidence showed significant differences in year of study (P=0.002), major (P=0.048), and graduate major (P<0.001). There was a correlation between clinical confidence and year of study (r=0.261, P<0.001). Conclusion Most medical students have sufficient clinical knowledge on TC prevention, but there are still misconceptions related to TC screening. In addition, medical students lack confidence in communicating with patients. Comprehensive communication training should be integrated into the medical curriculum and clinical activities should be initiated earlier.
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Affiliation(s)
- Chuang Yang
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Xing Feng
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Department of Hepatobiliary, Breast and Thyroid Surgery, the People’s Hospital of Liangping District, Chongqing, 405200, People’s Republic of China
| | - Junfeng Li
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Yuchan Jiang
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Huan Zhang
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Yidan Gao
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Jinxiang Tan
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Bolin Ran
- Department of Medical Laboratory Science, Laboratory of Traditional Chinese Medicine Hospital of Shizhu County, Chongqing, 409100, People’s Republic of China
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Lee M, Song Y, You M, Park SY, Ihm J. Dentists' attitudes toward patient-centered care and its predictors: a cross-sectional study in South Korea. BMC Oral Health 2023; 23:75. [PMID: 36747198 PMCID: PMC9903426 DOI: 10.1186/s12903-023-02791-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Patient-centered care (PCC) has been one of medical practice's most frequently discussed principles. However, attitudes toward PCC among dentists remain underexplored. This study focuses on examining dentists' patient-centered attitudes and investigating their predictors. METHODS The Patient-Practitioner Orientation Scale which consists of Sharing and Caring subscales was used to assess patient-centered attitudes. The statistical analysis included 217 dentists from South Korea. Hierarchical linear regression analysis was performed to examine the predictors such as sociodemographic aspects, academic factors, work-related factors, and empathy. RESULTS A patient-centered attitude of Caring subscale (M = 4.29, SD = 0.56) emerged, but the provider-centered attitude was higher in Sharing subscale (M = 3.40, SD = 0.48). Work year, academic track, and empathy were associated significantly with an overall caring aspect of patient-centered attitude, while the gender effect remained insignificant. Empathy had a critical and significant impact on the patient-centered attitude. CONCLUSIONS Efforts to enhance patient-centeredness in Sharing are needed; post-graduate education and transition to a more patient-centered health system are recommended. Moreover, empathy still matters as it was found to be a significant predictor of patient-centered attitudes. The findings of this study support the need for efforts to enhance patient-centered attitudes among dentists, which will help generate discussion on improving the curriculum of post-graduate education and health system reform.
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Affiliation(s)
- Minjung Lee
- grid.31501.360000 0004 0470 5905Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea ,grid.31501.360000 0004 0470 5905Department of Public Health Sciences, Seoul National University, Seoul, South Korea
| | - Youngha Song
- grid.31501.360000 0004 0470 5905Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea ,grid.31501.360000 0004 0470 5905Department of Preventive and Social Dentistry, Seoul National University, Seoul, South Korea
| | - Myoungsoon You
- grid.31501.360000 0004 0470 5905Department of Public Health Sciences, Seoul National University, Seoul, South Korea
| | - Shin-Young Park
- grid.31501.360000 0004 0470 5905Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea ,grid.31501.360000 0004 0470 5905Department of Dental Education, Seoul National University, Seoul, South Korea ,grid.459982.b0000 0004 0647 7483Predoctoral Treatment Center, Seoul National University Dental Hospital, Seoul, South Korea
| | - Jungjoon Ihm
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea. .,Department of Dental Education, Seoul National University, Seoul, South Korea. .,Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Korea.
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Englar RE, Graham Brett T. Integrating Communication Skills, Awareness of Self and Others, and Reflective Feedback into One Inclusive Anatomical Representation of Relationship-Centered Health Care. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20220060. [PMID: 36538494 DOI: 10.3138/jvme-2022-0060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The American Veterinary Medical Association Council on Education mandates in standard 11 that all accredited colleges of veterinary medicine must develop and deliver formal processes by which students are observed and assessed in nine competencies. The eighth competency combines clinical communication and sensitivity toward soliciting and understanding individual narratives across a diverse clientele to facilitate health care delivery. Several frameworks have been designed to structure health care consultations for teaching and coaching purposes. The Calgary-Cambridge guide (CCG) provides an evidence-based approach to outlining the flow of consultations, incorporating foundational communication skills and elements of relationship-centered care into a series of sequential tasks. Although the CCG was intended for use as a flexible tool kit, it lacks visible connections between concrete experiences (e.g., the consultation) and reflective observation (e.g., the feedback). This teaching tip describes the development of a novel anatomical representation of the consultation that integrates process elements of the CCG with other core curricular concepts. By combining knowledge, technical skills, critical thinking, reflection, cultural humility, and self-awareness into a skeletal consultation model, linkages are established between communication and intergroup dialogue skills, diversity and inclusion (D&I). This model has been further adapted as feline, caprine, porcine, equine, avian, and reptilian versions for in-class use as strategic visual aids that highlight key areas of focus for Professional Skills class sessions. Future developments by the authors will explore how to link species-specific consultation models to assessment rubrics to reinforce the connection between content (what) and process (how).
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Affiliation(s)
- Ryane E Englar
- Veterinary Skills Development, and Associate Professor of Practice, University of Arizona College of Veterinary Medicine, 1580 E Hanley Blvd./Oro Valley, AZ 85737 USA
| | - Teresa Graham Brett
- University of Arizona College of Veterinary Medicine, 1580 E Hanley Blvd./Oro Valley, AZ 85737 USA
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Bejarano G, Csiernik B, Young JJ, Stuber K, Zadro JR. Healthcare students' attitudes towards patient centred care: a systematic review with meta-analysis. BMC MEDICAL EDUCATION 2022; 22:324. [PMID: 35477455 PMCID: PMC9047330 DOI: 10.1186/s12909-022-03371-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patient centred care is commonly recommended in clinical practice guidelines to improve patient outcomes and reduce healthcare costs. Identifying measurement tools used to assess healthcare students' attitudes towards patient centered care and determining their attitudes is the first step to ensuring patient centred care is provided in the future. The primary aim of this review was to describe the measurement tools used to assess healthcare students' attitudes towards patient centred care. The secondary aim was to quantify healthcare students' attitudes towards patient centred care. METHODS An electronic database search was conducted in MEDLINE, EMBASE, CINAHL from inception until March 1, 2021, with combined terms relating to 'patient centred care', 'attitudes', and 'healthcare students'. Studies that quantitatively assessed healthcare students' attitudes towards patient centred care were included. Measurement tools used in the included studies were qualitatively described. Meta-analysis was conducted to quantify healthcare students' attitudes towards patient centred care and assess the respective influence of gender, profession, and study geographical location on healthcare students' attitudes towards patient centred care. RESULTS The electronic search identified 3948 total studies. One hundred twenty-nine full texts were screened, and 49 studies were included. There were 16 measurement tools used to assess healthcare students' attitudes towards patient centered care. Most studies (53%, n = 26) used the Patient-Practitioner Orientation Scale (PPOS) to assess patient centered care. Meta-analyses of 20 studies with 26 total groups resulted in a pooled mean PPOS score of 4.16 on a 0-6 scale (95% Confidence Interval [CI]: 3.95, 4.37), indicating low attitudes towards patient centered care. Additional analyses found that women have significantly higher attitudes towards patients centred care than men (pooled effect 0.14 [95% CI: 0.05, 0.23], n = 8 studies) and mean PPOS scores appear similar among sub-groups of only medical students (pooled mean 4.13, 95% CI: 3.85, 4.42, n = 13 studies) and only American healthcare students (pooled mean 4.49, 95% CI: 4.35, 4.64, n = 5 studies). CONCLUSIONS Several different measurement tools have been used to assess healthcare students' attitudes towards patient centred care, but the most commonly used is the PPOS. Our results indicate that healthcare students have low attitudes towards patient centred care. Future studies should evaluate if attitudes towards patient centred care can be improved during healthcare education.
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Affiliation(s)
- Geronimo Bejarano
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), 1616 Guadalupe Street, Austin, TX, 78702, USA.
| | - Ben Csiernik
- Canadian Memorial Chiropractic College, Toronto, Canada
| | - James J Young
- Canadian Memorial Chiropractic College, Toronto, Canada
- Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Kent Stuber
- Canadian Memorial Chiropractic College, Toronto, Canada
| | - Joshua R Zadro
- Sydney School of Public Health, Faculty of Medicine and Health, Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, New South Wales, Australia
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Escribano S, Juliá-Sanchis R, Perpiñá-Galvañ J, Congost-Maestre N, Cabañero-Martínez MJ. Spanish linguistic validation of the Self-efficacy questionnaire in communication skills. Contemp Nurse 2021; 58:161-170. [PMID: 34873987 DOI: 10.1080/10376178.2021.2015415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Self-efficacy is a critical element of social cognitive theory and refers to a person's estimation of their ability to complete a specific task. Self-efficacy scales evaluate the effectiveness of communication skills training programs. There were not validated scales in Spanish. Aims: to cross-culturally adapt the Self-efficacy questionnaire-12 scale in communication skills in Spanish, evaluate its psychometric properties, and analyse the sample's descriptive characteristics. Design: we conducted an instrumental study to develop evaluation scales. Methods: nursing students were invited to participate (N = 387). The inclusion criteria were: (1) enrolment in first or fourth academic course year; (2) not having received specific training in communication skills; and (3) understanding written and spoken Spanish fluently. A total of 334 undergraduates participated (86.3% response rate); their mean age was 21.9 years (SD = 5.8), 83.2% were female. Results: data showed high internal consistency (0.94) and a good fit to the model. The overall instrument score correlated with the attitude towards communication skills (r = 0.20; p < 0.001). Moderate communication self-efficacy scores were observed in these nursing students. Impact statement: Evaluating communication skills through self-efficacy scales allows teachers to know each student's perceived proficiency to handle communication with users safely and to understand users' needs, giving information about aspects to improve and to establish effective institutional strategies as one of the inherent characteristics of the concept of skills-based evaluation. Conclusions: The Spanish version of the Self-efficacy questionnaire-12 in communication skills was a valid and reliable instrument, essential for evaluating the perceived self-efficacy towards communication in nursing.
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Affiliation(s)
- Silvia Escribano
- Department of Nursing, Faculty of Health Science, University of Alicante, Spain.
| | - Rocío Juliá-Sanchis
- Department of Nursing, Faculty of Health Science, University of Alicante; Carretera de San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante (Spain). Tel: (+34) 96 590 3512
| | - Juana Perpiñá-Galvañ
- Department of Nursing, Faculty of Health Science, University of Alicante, Spain.
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Berkowitz J, Martinez-Camblor P, Stevens G, Elwyn G. The development of incorpoRATE: A measure of physicians' willingness to incorporate shared decision making into practice. PATIENT EDUCATION AND COUNSELING 2021; 104:2327-2337. [PMID: 33744056 DOI: 10.1016/j.pec.2021.02.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To develop 'incorpoRATE', a brief and broadly applicable measure of physicians' willingness to incorporate shared decision making (SDM) into practice. METHODS incorpoRATE was developed across three phases: 1) A review of relevant literature to inform candidate domain and item development, 2) Cognitive interviews with US physicians to iteratively refine the measure, and 3) Pilot testing of the measure across a larger sample of US physicians to explore item and measure performance. RESULTS The final measure consists of seven items that assess physician perspectives on various components of SDM use that may present as barriers in practice. During pilot testing, the majority of physicians expressed positive opinions about the overall concept of SDM, yet were less comfortable acting on informed patient choices when there was known incongruence with their own recommendations. CONCLUSIONS incorpoRATE is a novel physician-reported measure that assesses physicians' willingness to incorporate SDM in practice. PRACTICE IMPLICATIONS incorpoRATE has the potential to help us further understand the limited adoption of SDM and areas of focus for improving the use of SDM in the future. We recommend that incorpoRATE be subject to further psychometric, real-world testing, in order to explore its performance across different samples of physicians and organizations.
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Affiliation(s)
- Julia Berkowitz
- The Dartmouth Institute for Health Policy and Clinical Practice, Williamson Translational Research Building, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Pablo Martinez-Camblor
- The Dartmouth Institute for Health Policy and Clinical Practice, Williamson Translational Research Building, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Gabrielle Stevens
- The Dartmouth Institute for Health Policy and Clinical Practice, Williamson Translational Research Building, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Williamson Translational Research Building, 1 Medical Center Drive, Lebanon, NH 03756, USA.
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Cabañero-Martínez MJ, García-Sanjuán S, Escribano S, Fernández-Alcántara M, Martínez-Riera JR, Juliá-Sanchís R. Mixed-method study on the satisfaction of a high-fidelity simulation program in a sample of nursing-degree students. NURSE EDUCATION TODAY 2021; 100:104858. [PMID: 33713986 DOI: 10.1016/j.nedt.2021.104858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/12/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Training emotionally complex communication skills with standardized patients brings realism to simulation scenarios, and moreover, is associated with high levels of satisfaction among the students. OBJECTIVES (1) To measure the satisfaction of nursing students and factors related to their satisfaction and (2) to explore the effects perceived by nursing students after having a high-fidelity simulation training program using standardized patients. DESIGN AND PARTICIPANTS Mixed design. Pre-post quasi-experimental phase in which the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation was administered in 156 students; a second, semi-structured interview qualitative phase was completed by 11 students. RESULTS Nursing students showed high satisfaction scores. The scores for utility and communication were correlated with the students' attitudes towards communication. In the second phase, two main themes and four sub-themes emerged. CONCLUSIONS Teachers could implement high-fidelity simulation programs with standardized patients for training emotionally complex communication skills to nursing students. These programs allow students to participate in their own learning processes and help them to feel motivated and satisfied about the usefulness of their learning experiences.
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Affiliation(s)
- María José Cabañero-Martínez
- Nursing Department, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Alicante s/n-03690, P.O.B: 99, Spain.
| | - Sofía García-Sanjuán
- Nursing Department, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Alicante s/n-03690, P.O.B: 99, Spain.
| | - Silvia Escribano
- Nursing Department, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Alicante s/n-03690, P.O.B: 99, Spain.
| | - Manuel Fernández-Alcántara
- Health Psychology Department, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Alicante s/n-03690, P.O.B: 99, Spain.
| | - José Ramón Martínez-Riera
- Department of Community Intervention and History, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Alicante s/n-03690, P.O.B: 99, Spain.
| | - Rocio Juliá-Sanchís
- Nursing Department, Health Sciences Faculty, University of Alicante, San Vicente del Raspeig, Alicante s/n-03690, P.O.B: 99, Spain.
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Goto Y, Miura H, Son D, Scholl I, Kriston L, Härter M, Sato K, Kusaba T, Arai H. Association between physicians' and patients' perspectives of shared decision making in primary care settings in Japan: The impact of environmental factors. PLoS One 2021; 16:e0246518. [PMID: 33566830 PMCID: PMC7875412 DOI: 10.1371/journal.pone.0246518] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/20/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Shared decision-making (SDM) has only lately begun attaining recognition from the Japanese medical community. The purpose of this study was to create a Japanese version of the SDM-Q-Doc, which is a scale that measures SDM from the perspective of physicians, and to clarify its psychometric characteristics and identify the issues and factors that affect SDM. METHODS The participants were 23 physicians and 130 patients who visited primary care clinics in Japan for the first time. Immediately following physician-patient interviews, the Japanese version of SDM-Q-9 and SDM-Q-Doc were administered to patients and physicians, respectively. For convergent validity, physician confidence in the medical interview (PCMI) was used. After the determination of internal consistency and validity of the SDM-Q-Doc, the relations among each item of SDM-Q-Doc, SDM-Q-9, physicians' sociodemographic attributes, and a presence or absence of nurse's attendance during outpatient consultation were assessed by a multiple regression analysis and structural equation modeling (SEM). RESULTS A factor analysis confirmed that the Japanese version of the SDM-Q-Doc displays a one-factor structure with a high internal consistency (Cronbach's α = 0.87, ω = 0.88). The correlation between the PCMI and SDM-Q-Doc confirmed an appropriate convergent validity (r = 0.406; p < 0.001). Multiple regression analyses showed that the attendance of a nurse during consultation significantly affected one item of the SDM-Q-Doc, which in turn affected one item of the SDM-Q-9. SEM showed a good fit of model for these three items. CONCLUSION The Japanese version of the SDM-Q-Doc's internal consistency and validity in the outpatient medical consultations in Japan were confirmed. Further, this study suggests the role of a nurse's attendance during a physician-patient consultation on facilitating the SDM. Further, using the Japanese version of the SDM-Q-Doc will promote communication skills training for medical professionals by checking the quality of SDM.
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Affiliation(s)
- Yuko Goto
- Department of Home Care and Regional Liaison Promotion, National Center for Geriatrics and Gerontology of Japan, Obu, Japan
- * E-mail:
| | - Hisayuki Miura
- Department of Home Care and Regional Liaison Promotion, National Center for Geriatrics and Gerontology of Japan, Obu, Japan
| | - Daisuke Son
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kotaro Sato
- The Hokkaido Center for Family Medicine, Hokkaido, Japan
| | - Tesshu Kusaba
- The Hokkaido Center for Family Medicine, Hokkaido, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology of Japan, Obu, Japan
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Michael K, Dror MG, Karnieli-Miller O. Students' patient-centered-care attitudes: The contribution of self-efficacy, communication, and empathy. PATIENT EDUCATION AND COUNSELING 2019; 102:2031-2037. [PMID: 31257098 DOI: 10.1016/j.pec.2019.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 05/10/2019] [Accepted: 06/07/2019] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Patient-centered-care (PCC) attitudes are important to enhance PCC behavior, but research on perceptions and attitudes that contribute to PCC attitudes is limited. We tested a new model, assessing whether the association between self-efficacy and PCC attitudes is mediated by communication and empathy attitudes. Furthermore, we assessed medical-school-stage and gender differences in these variables. METHODS Medical/dentistry students (N = 653) completed self-reported questionnaires. Analyses were performed using Pearson's-correlations, PROCESS macro, and independent samples t-tests. RESULTS The association between communication self-efficacy and PCC attitudes was completely mediated by communication and empathy attitudes. Students in clinical years had more positive attitudes toward PCC and empathy, and higher communication self-efficacy. Females had more positive attitudes toward PCC, communication, and empathy. CONCLUSIONS The results emphasize the importance of communication self-efficacy and the mediating role of communication and empathy attitudes in enhancing PCC attitudes. This highlights the need to focus on learners' affective matter (what they feel/think) about their competencies and attitudes. PRACTICE IMPLICATIONS Educational interventions should improve understanding of the benefits of applying good communication skills, of learning the importance of empathy and its relevance to patient care, and strengthening students' confidence in applying these skills. Attention to these is important for enhancing students' PCC attitudes.
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Affiliation(s)
- Keren Michael
- Department of Human Services, The Max Stern Yezreel Valley Academic College, Yezreel Valley, Israel.
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Chang CW, Huang HC, Wang SJ, Lee H. Relational bonds, customer engagement, and service quality. SERVICE INDUSTRIES JOURNAL 2019. [DOI: 10.1080/02642069.2019.1611784] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Chia-Wen Chang
- Department of International Business, National Taipei University of Business, Taiwan, Republic of China
| | - Heng-Chiang Huang
- Department of International Business, National Taiwan University, Taiwan, Republic of China
| | - Shih-Ju Wang
- Graduate Institute of Management, National Taiwan Normal University, Taiwan, Republic of China
| | - Han Lee
- Department of International Business, National Taiwan University, Taiwan, Republic of China
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Mahlich J, Schaede U, Sruamsiri R. Shared Decision-Making and Patient Satisfaction in Japanese Rheumatoid Arthritis Patients: A New "Preference Fit" Framework for Treatment Assessment. Rheumatol Ther 2019; 6:269-283. [PMID: 31049848 PMCID: PMC6513920 DOI: 10.1007/s40744-019-0156-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION We have developed a new framework to assess shared decision-making (SDM) as a tool to improve patient satisfaction. This framework is based on a "preference fit" index that relates SDM to patient treatment preferences and patient satisfaction in a sample of rheumatoid arthritis (RA) patients in Japan. METHODS We surveyed 500 RA patients in Japan and explored the interactions between the treatment preference fit index, SDM, and overall patient satisfaction. RESULTS Our new preference fit index reveals significant impact on patient satisfaction: the better the fit between SDM and patient preferences, the higher the patient satisfaction with the current treatment. Patients treated with biologic agents were more satisfied. Patients suffering from depression or migraines scored significantly lower both on our preference fit measure and for overall patient satisfaction. CONCLUSION The association between depression and a low treatment preference fit suggests that depression may pose challenges to SDM and that doctors in Japan are less attuned to the SDM preferences of depressed patients. FUNDING Janssen Pharmaceutical KK.
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Affiliation(s)
- Jörg Mahlich
- Health Economics and Outcomes Research, Janssen-Cilag, Neuss, Germany.
- Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany.
| | | | - Rosarin Sruamsiri
- Center of Pharmaceutical Outcomes Research, Naresuan University, Phitsanulok, Thailand
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Self-assessment of residents in respect of attitudes to communication. Prim Health Care Res Dev 2019; 20:e32. [PMID: 32800016 PMCID: PMC6476388 DOI: 10.1017/s1463423618000920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim As communication skills are essential for medical practice, many medical schools have added communication skills training to their curricula in recent years. The aim of this study was to determine and compare the attitudes to communication skills of family medicine, internal medicine and general surgery residents. Materials and methods Family medicine, internal medicine and general surgery residents of three training and research hospitals and one university hospital in Ankara were included in this cross-sectional study. A questionnaire was used for obtaining information about age, gender, marital status, graduation date and whether receiving any training for communication skills. The Turkish version of the Communication Skills Attitude Scale was used. Results In all, 58 (50%) family medicine, 30 (25.9%) internal medicine, and 28 (24.1%) general surgery residents were accepted to participate in the study. Of the 116 residents, 58 (50%) were female and 58 (50%) were male, with a mean age of 29.47±4.63 years, and 68 (58.6%) of them were married; 59.5% of the participants received training about communication skills and 56.5% of them received it at medical school. The mean positive attitude scale (PAS) score was 3.85±0.58, and the mean negative attitude scale (NAS) score was 2.42±0.52. The PAS scores of female residents were higher than those of males (P=0.01). The PAS scores of residents who received communication skills training were higher than the scores of those who had not (P=0.01). The PAS scores of family medicine residents were higher and the NAS scores were lower than those of internal medicine and general surgery residents. Conclusion The communication skill attitudes of family medicine residents were better than those of internal medicine and general surgery residents.
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Ishikawa H, Son D, Eto M, Kitamura K, Kiuchi T. Changes in patient-centered attitude and confidence in communicating with patients: a longitudinal study of resident physicians. BMC MEDICAL EDUCATION 2018; 18:20. [PMID: 29370796 PMCID: PMC5785873 DOI: 10.1186/s12909-018-1129-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 01/17/2018] [Indexed: 05/06/2023]
Abstract
BACKGROUND Patient-centered care has been one of the most frequently discussed principles in medical practice. However, there is a serious concern that the patient-centered attitudes of physicians diminish over the course of their medical education. This longitudinal study examined changes in resident physicians' patient-centered attitudes and their confidence in communicating with patients, and explored the relationship between the two traits. METHODS The study participants were resident physicians at a university hospital in Tokyo. Participants' patient-centered attitudes (as measured by the Patient-Practitioner Orientation Scale [PPOS]), and their confidence in communicating with patients (as per the Physician Confidence in the Medical Interview scale: [PCMI]) were assessed through self-reported questionnaires completed at the beginning of residency (n = 204) and again at the end of the first year (n = 95). RESULTS PPOS scores declined significantly during the year, both in terms of attitude toward sharing information and decision-making with patients, and attitude of caring for patients' expectations and emotions. The shift in caring attitude differed significantly by gender. The increase in PCMI score was greater for those with a smaller decrease in PPOS score. CONCLUSIONS As seen in previous studies of medical students, resident physicians' patient-centered attitudes declined during their first year of residency, while there may be a gender-based difference within the shift. The increase in physicians' confidence in communicating with patients was greater for those who showed a smaller decline in patient-centered attitude. Additional studies are needed to detail the changes in physicians' attitudes, confidence, and communication skills over the course of their medical training, and to develop systematic assessment and training programs.
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Affiliation(s)
- Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Daisuke Son
- International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Masato Eto
- International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
- General Education Center, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Kiyoshi Kitamura
- School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita-shi, Chiba, 286-8686 Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
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Wang J, Zou R, Fu H, Qian H, Yan Y, Wang F. Measuring the preference towards patient-centred communication with the Chinese-revised Patient-Practitioner Orientation Scale: a cross-sectional study among physicians and patients in clinical settings in Shanghai, China. BMJ Open 2017; 7:e016902. [PMID: 28928188 PMCID: PMC5623567 DOI: 10.1136/bmjopen-2017-016902] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To adapt the Patient-Practitioner Orientation Scale (PPOS), to a Chinese context, and explore the preference towards patient-centred communication among physicians and patients with the Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS). DESIGN A cross-sectional questionnaire-based study. SETTING Clinical settings from eight medical units, including four community hospitals and four general hospitals, in Shanghai, China. PARTICIPANTS 1018 participants, including 187 physicians and 831 patients, completed this study in two successive stages. OUTCOME MEASUREMENTS Psychometric properties of the CR-PPOS and participants' score on the CR-PPOS. RESULTS Compared with the original PPOS, the 11-item CR-PPOS obtained better psychometric indices. Physicians and patients scored differently on both the total CR-PPOS and its two subscales. Compared with physicians, the scores of patients were more influenced by their personal characteristics, such as age and education. CONCLUSIONS The CR-PPOS is a better instrument in a Chinese context than the original translated version. The divergence in the extent to which patient-centred communication is preferred among Chinese physicians and patients should be noted. Adapting physicians' communication strategy to patients' preferences based on their personal characteristics can be a viable approach towards improving clinical efficiency.
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Affiliation(s)
- Jie Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Runyu Zou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hua Fu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Haihong Qian
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yueren Yan
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Fan Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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Schaede U, Mahlich J, Nakayama M, Kobayashi H, Takahashi Y, Saito K, Uemura H, Tokumitsu M, Yoshizawa K. Shared Decision-Making in Patients With Prostate Cancer in Japan: Patient Preferences Versus Physician Perceptions. J Glob Oncol 2017; 4:1-9. [PMID: 30241183 PMCID: PMC6180796 DOI: 10.1200/jgo.2016.008045] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This article adds the Japanese perspective to our knowledge of shared
decision-making (SDM) preferences by surveying patients with prostate cancer
(PCA) and physicians in Japan. In 2015, 103 Japanese patients with PCA were
asked about their SDM preferences by using an Internet-based 5-point-scale
questionnaire. Concurrently, 127 Japanese physicians were surveyed regarding
their perceptions of patient preferences on SDM. Drivers of preferences and
perceptions were analyzed using univariable ordinal logistic regression and
graphing the fitted response probabilities. Although 41% of both patients and
physicians expressed and expected a desire for active involvement in treatment
decisions (a higher rate than in a similar study for the United States in 2001),
almost half the Japanese patients preferred SDM, but only 33% of physicians
assumed this was their choice. That is, 29% of Japanese physicians
underestimated patients’ preference for involvement in making treatment
decisions. Patients with lower health-related quality of life (as measured by
the Functional Assessment of Cancer Therapy-Prostate [FACT-P]) expressed a
stronger preference for SDM. The study shows that the worse the medical
situation, the more patients with PCA prefer to be involved in the treatment
decision, yet physicians tend to underestimate the preferences of their
patients. Perhaps in contrast to common assumptions, Japanese patients are as
interested in being involved in decision making as are patients in the United
States.
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Affiliation(s)
- Ulrike Schaede
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Jörg Mahlich
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Masahiko Nakayama
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Hisanori Kobayashi
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Yuriko Takahashi
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Katsuhiko Saito
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Hiroji Uemura
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Masayuki Tokumitsu
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
| | - Kazutake Yoshizawa
- Ulrike Schaede, University of California at San Diego, San Diego, CA; Jörg Mahlich, Janssen Pharmaceutical K.K., Tokyo, Japan, and University of Düsseldorf, Düsseldorf, Germany; Masahiko Nakayama, Hisanori Kobayashi, and Kazutake Yoshizawa, Janssen Pharmaceutical K.K.; Yuriko Takahashi and Katsuhiko Saito, Anterio, Tokyo; Hiroji Uemura, Yokohama City University, Medical Center, Yokohama; and Masayuki Tokumitsu, Kitasaito Hospital, Ashikawa, Japan
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Ishikawa H, Son D, Eto M, Kitamura K, Kiuchi T. The information-giving skills of resident physicians: relationships with confidence and simulated patient satisfaction. BMC MEDICAL EDUCATION 2017; 17:34. [PMID: 28178986 PMCID: PMC5299673 DOI: 10.1186/s12909-017-0875-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/01/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND Sharing information is crucial for discussion of problems and treatment decision making by patients and physicians. However, the focus of communication skills training in undergraduate medical education has been on building the relationship and gathering information; thus, resident physicians tend to be less confident about sharing information and planning treatment. This study evaluated the medical interviews conducted by resident physicians with a focus on information giving, and investigated its relationships with their confidence in communication and simulated patient (SP) satisfaction. METHODS Among 137 junior resident physicians at a university hospital in Japan who participated in a survey of communication skills, 25 volunteered to conduct simulated medical interviews. The medical interviews were video-recorded and analyzed using the Roter Interaction Analysis System, together with additional coding to explore specific features of information giving. The SPs evaluated their satisfaction with the medical interview. RESULTS Resident physicians who were more confident in their communication skills provided more information to the patients, while SP satisfaction was associated only with patient-prompted information giving. SPs were more satisfied when the physicians explained the rationales for their opinions and recommendations. CONCLUSION Our findings underscore the importance of providing relevant information in response to the patient requests, and explaining the rationales for the opinions and recommendations. Further investigation is needed to clinically confirm our findings and develop an appropriate communication skills training program.
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Affiliation(s)
- Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Daisuke Son
- International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masato Eto
- General Education Center, University of Tokyo Hospital, Tokyo, Japan
| | - Kiyoshi Kitamura
- International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- General Education Center, University of Tokyo Hospital, Tokyo, Japan
- Present Address: International University of Health and Welfare, Chiba, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Pollard S, Bansback N, Bryan S. Physician attitudes toward shared decision making: A systematic review. PATIENT EDUCATION AND COUNSELING 2015; 98:1046-57. [PMID: 26138158 DOI: 10.1016/j.pec.2015.05.004] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 03/26/2015] [Accepted: 05/11/2015] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Although evidence suggests that shared decision-making (SDM) can improve patient outcomes, uptake to date has been sparse. The purpose of this review was to determine the reported opinions of physicians regarding the use of SDM in clinical practice and to identify strategies to promote uptake. METHODS We conducted a systematic review, including papers published between 2007 and 2014. RESULTS The electronic search yielded 11,761 results. Following abstract review, 123 papers were selected for full text review, and 43 papers were included for analysis. Fourteen of the included studies considered SDM within the context of primary care, 25 in secondary care, and 4 in both. CONCLUSIONS Physicians express positive attitudes toward SDM in clinical practice, although the level of support varies by clinical scenario, treatment decision and patient characteristics. PRACTICE IMPLICATIONS Physician support for SDM is a necessary, if not sufficient, condition to facilitate meaningful SDM. In order to garner support for SDM, additional empirical evidence regarding the clinical and patient important outcomes must be established. Based on the results of this review, the authors suggest assessing the impact of SDM within the context of chronic disease management where multiple therapeutic options exist, and outcomes may be measured long-term.
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Affiliation(s)
- Samantha Pollard
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, Canada.
| | - Nick Bansback
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, Canada; Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, Canada
| | - Stirling Bryan
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, Canada
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