Bringing personal perspective elicitation to the heart of shared decision-making: a scoping review: Presenter(s): Ester Rake, Radboud university medical center; Knowledge Institute of the Dutch Federation of Medical Specialists, Netherlands. (April 2023)

• Record Type: Journal Article
• Authors: Box, Ivana; Dreesens, Dunja; Meinders, Marjan; Kremer, Jan; Aarts, Johanna; Elwyn, Glyn
• Is Part Of: Patient education and counseling. Volume 109(2023)Supplement
• Page Start: 97
• Publication Date: 2023-04
• Subjects: Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2022.10.226
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract : Background: Proponents of shared decision-making (SDM) advocate the elicitation of the patient's perspective. However, we hypothesise that this is neglected in clinical practice. This scoping review explores if, and to what extent, the personal perspectives of patients are elicited during a clinical encounter, as part of a SDM process. Methods: A search was conducted in five literature databases from inception up to July 2020, to identify qualitative and quantitative empirical studies about SDM. We define personal perspective elicitation (PPE) as: the disclosure (either elicited by the clinician or spontaneously expressed by the patient) of information related to the patient's personal preferences, values and/or context. Based on a list of existing SDM instruments, we scored which instruments contained item(s) reflecting PPE and included those instruments in our analysis. Findings: We identified 4562 abstracts; 263 full text articles, and included 99 studies. Both qualitative and quantitative studies reported low levels of PPE. 52 used an SDM instrument (quantitative approach), 45 were qualitative studies and 2 had mixed approaches. The 54 studies with PPE-related items reported scores that indicated low levels of PPE. More specifically, in 40 studies reporting the Observer OPTION 5 and 12, the items that matched our definition of PPE ranged from 0.4 to 1.7 on a scale from 0 to 4 with a score of 0 reflecting absent behaviour to explore personal preferences. Of the 47 qualitative studies, 24 were categorised as low personal perspective elicitation, 8 as medium and 6 as high, while 9 studies could not be categorised. Discussion: Personal perspective elicitation, being recognized as an essential element of SDM, occurs on a low level in efforts to achieve SDM. To bridge this gap, possible causes should be identified followed by designing interventions and implementation strategies to improve this aspect of SDM.