Developing a Shared Decision-Making Model for Diabetic Patients: A Qualitative Study

Overview

Journal Galen Med J

Specialty General Medicine

Date 2022 Apr 18

PMID 35434155

Authors

Khorshid Vaskouei-Eshkevarei

Kamran Hajinabi

Leila Riahi

Mohammadreza Maleki

Affiliations

Soon will be listed here.

Abstract

Background: Patient participation in healthcare leads to increased satisfaction and trust, reduction of anxiety, and a better understanding of patients' needs. The components of shared decision-making (SDM) are well documented in the literature. The purpose of this study was to design an SDM model for diabetic patients.

Materials And Methods: This qualitative content analysis study was performed in three steps. First, a descriptive comparative study was conducted using the widely-used George Brady method. Next, the perceptions of participants (both physicians and patients) were collected via interview and in focus group discussions (FGDs). Content analysis was used to categorize the comments made by participants. In the final step, the model of SDM for diabetic patients was designed based on expert panel discussions.

Results: Twelve components were extracted from the comparative study. Two themes and six sub-themes were extracted from data resulting from physicians' interviews, and two themes and ten sub-themes were extracted from data resulting from the FGDs involving patients. The model of SDM for diabetic patients was designed in light of three concepts; practitioners' behavior, participatory decision-making process, and patients' autonomy.

Conclusion: This model was valuable because it recognizes the process of SDM in the context of Iran. The model's main purpose was to help choose optimum strategies for the care of diabetic patients within the health sector.

References

Gravel K, Legare F, Graham I . Barriers and facilitators to implementing shared decision-making in clinical practice: a systematic review of health professionals' perceptions. Implement Sci. 2006; 1:16. PMC: 1586024. DOI: 10.1186/1748-5908-1-16. View

Serrano V, Larrea-Mantilla L, Rodriguez-Gutierrez R, Spencer-Bonilla G, Malaga G, Hargraves I . [Shared decision making in patients with diabetes mellitus]. Rev Med Chil. 2017; 145(5):641-649. DOI: 10.4067/S0034-98872017000500012. View

Grol R, Wensing M . What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004; 180(S6):S57-60. DOI: 10.5694/j.1326-5377.2004.tb05948.x. View

Legare F, Stacey D, Gagnon S, Dunn S, Pluye P, Frosch D . Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study. J Eval Clin Pract. 2010; 17(4):554-64. PMC: 3170704. DOI: 10.1111/j.1365-2753.2010.01515.x. View

Charles C, Gafni A, Whelan T . Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997; 44(5):681-92. DOI: 10.1016/s0277-9536(96)00221-3. View

Siminoff L, Step M . A communication model of shared decision making: accounting for cancer treatment decisions. Health Psychol. 2005; 24(4S):S99-S105. DOI: 10.1037/0278-6133.24.4.S99. View

Longtin Y, Sax H, Leape L, Sheridan S, Donaldson L, Pittet D . Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc. 2010; 85(1):53-62. PMC: 2800278. DOI: 10.4065/mcp.2009.0248. View

Ben-Zacharia A, Adamson M, Boyd A, Hardeman P, Smrtka J, Walker B . Impact of Shared Decision Making on Disease-Modifying Drug Adherence in Multiple Sclerosis. Int J MS Care. 2018; 20(6):287-297. PMC: 6295876. DOI: 10.7224/1537-2073.2017-070. View

Durand M, Moulton B, Cockle E, Mann M, Elwyn G . Can shared decision-making reduce medical malpractice litigation? A systematic review. BMC Health Serv Res. 2015; 15:167. PMC: 4409730. DOI: 10.1186/s12913-015-0823-2. View

10.

Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P . Shared decision making: a model for clinical practice. J Gen Intern Med. 2012; 27(10):1361-7. PMC: 3445676. DOI: 10.1007/s11606-012-2077-6. View

11.

Peters R . Matching physician practice style to patient informational issues and decision-making preferences. An approach to patient autonomy and medical paternalism issues in clinical practice. Arch Fam Med. 1994; 3(9):760-3; discussion 764. DOI: 10.1001/archfami.3.9.760. View

12.

Lee Y, Low W, Jenn Ng C . Exploring patient values in medical decision making: a qualitative study. PLoS One. 2013; 8(11):e80051. PMC: 3839918. DOI: 10.1371/journal.pone.0080051. View

13.

Kolovos P, Kaitelidou D, Lemonidou C, Sachlas A, Sourtzi P . Patient Participation in Decision Making During Nursing Care in Greece--A Comparative Study. Nurs Forum. 2014; 50(3):147-57. DOI: 10.1111/nuf.12089. View

14.

Nakayama T . [Evidence-based Risk and Benefit Communication for Shared Decision Making]. Yakugaku Zasshi. 2018; 138(3):331-334. DOI: 10.1248/yakushi.17-00185-5. View

15.

Brown J, Harris S, Webster-Bogaert S, Wetmore S, Faulds C, Stewart M . The role of patient, physician and systemic factors in the management of type 2 diabetes mellitus. Fam Pract. 2002; 19(4):344-9. DOI: 10.1093/fampra/19.4.344. View

16.

Tinelli M, Petrou P, Samoutis G, Traynor V, Olympios G, McGuire A . Implementing shared-decision-making for diabetes care across country settings: What really matters to people?. Health Policy. 2017; 121(7):786-792. DOI: 10.1016/j.healthpol.2017.05.001. View

17.

Elwyn G, Durand M, Song J, Aarts J, Barr P, Berger Z . A three-talk model for shared decision making: multistage consultation process. BMJ. 2017; 359:j4891. PMC: 5683042. DOI: 10.1136/bmj.j4891. View

18.

Emanuel E, Emanuel L . Four models of the physician-patient relationship. JAMA. 1992; 267(16):2221-6. View

19.

Scholl I, Koelewijn-Van Loon M, Sepucha K, Elwyn G, Legare F, Harter M . Measurement of shared decision making - a review of instruments. Z Evid Fortbild Qual Gesundhwes. 2011; 105(4):313-24. DOI: 10.1016/j.zefq.2011.04.012. View

20.

Souliotis K, Agapidaki E, Peppou L, Tzavara C, Varvaras D, Buonomo O . Assessing Patient Organization Participation in Health Policy: A Comparative Study in France and Italy. Int J Health Policy Manag. 2018; 7(1):48-58. PMC: 5745867. DOI: 10.15171/ijhpm.2017.44. View