Effective communication and shared decision making: Theoretical approach from the doctor-patient relationship approach
DOI:
https://doi.org/10.56294/mw202212Keywords:
Shared Decision Making, Decision Support Techniques, Decision Tools, Decision ModelingAbstract
Introduction: shared decision making is understood as a communicational model in which health personnel collaborate with the patient or caregiver in making optimal health decisions, encouraging patients, family members and physicians to evaluate clinical information and compare risk-benefit in order to select the most appropriate treatment option.
Objective: to characterize shared decision making as a model of patient-physician communication.
Development: the method has gained acceptance among the medical community in recent years; despite having an approach in line with current medicine due to benefits such as a decrease in medical errors, being associated with a better overall quality of decisions and less decisional conflict, its use is controversial due to weaknesses such as lack of practical guidelines for its use, lack of training for the parties involved, lack of time and applicability due to the patient's characteristics. Shared decision support tools provide information about the options and potentially expected outcomes for a person's health status, and are different from traditional educational materials.
Conclusions: shared decision making emerges as a method of patient-physician communication centered on the participation of the patient in his or her medical therapy and is credited with reducing decisional uncertainty. The scientific evidence is insufficient to recommend its use over traditional methods, although its application has gained acceptance among the international community in recent years
References
1. Szasz T, Hollender M. A contribution to the philosophy of medicine: the basic models of the doctor–patient relationship. Arch. Intern. Med. 1956; 97:585–92. https://doi.org/10.1001/archinte.1956.00250230079008
2. Veatch RM. Models for ethical medicine in a revolutionary age. What physician-patient roles foster the most ethical relationship? Hastings Cent. Rep. 1972; 2(3):5–7. https://doi.org/10.2307/3560825
3. Pieterse A, Finset A. Shared decision making—Much studied, much still unknown. Patient Education and Counseling. 2019; 102:1946–1948. https://doi.org/10.1016/j.pec.2019.09.006
4. Canton C. Ética en la toma de decisiones compartida. Arch Argent Pediatr. 2023; 121(1):e202202754. http://dx.doi.org/10.5546/aap.2022-02754
5. Légaré F, Adekpedjou R, Stacey D, Turcotte S, Kryworuchko J, Graham ID, et al. Interventions for increasing the use of shared decision making by healthcare professionals. Cochrane Database Syst. Rev. 2018; 7(7):CD006732. https://doi.org/10.1002/14651858.CD006732.pub4
6. Li X, Yang D, Meng M, Zhao J, Yin Y, Wang H, et al. Shared decision-making in healthcare in mainland China: a scoping review. Frontiers in Public Health. 2023;11:1162993. https://doi.org/10.3389/fpubh.2023.1162993
7. Padilla Garrido N, Aguado Correa F, Bayo Lozano E, Bayo Calero J, Ortiga Moreno M. Conocimiento y evaluación de la toma de decisiones compartidas en la práctica oncológica desde el punto de vista médico. Rev Esp Salud Pública. 2019;93(9):e201910066. https://recyt.fecyt.es/index.php/RESP/article/view/75255
8. Palacios A. La toma de decisiones compartidas en América Latina. Global Rheumatology. 2022;3(2):e139. https://doi.org/10.46856/grp.22.e139
9. Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;(4). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001431.pub5/full/es
10. Faiman B, Tariman J. Shared Decision Making. Improving patient outcomes by understanding the benefits of and barriers to effective communication. Clinical Journal Of Oncology Nursing. 2019; 23(5):540-542. https://doi.org/10.1188/19.CJON
11. Perestelo Pérez L, Pérez Ramos Jeanette, Rivero Santana A. Toma de decisiones compartidas en oncología. Psicooncología. 2010;7(2-3):233-241.
12. Farías ME. Calidad de atención y cuidado de enfermería en servicio de emergencia visto desde la perspectiva del paciente. Salud, Ciencia y Tecnología 2021;1:39–39. https://doi.org/10.56294/saludcyt202139
13. Lantos J. Ethical Problems in Decision Making in the Neonatal ICU. N Engl J Med. 2018; 379(19):1851-60. https://doi.org/10.1056/NEJMre1801063
14. Bases éticas de la toma de decisiones compartidas en niños con patología crónica compleja y/o cuidados paliativos. Salinas Sanz A, Rodríguez Nuñez A, Sáchez Jacob M, Tasso Cereceda M, Riaño Galán I, Río Pastoriza. Sociedad Española de Cuidados Paliativos Pediátricos. 2022. https://www.pedpal.es/site/protocolos-pedpal/
15. Bajenaru L, Sorici A, Georgiana Mocanu I, Florea AM, Anca Antochi F, Ribigan AC. Shared Decision-Making to Improve Health-Related Outcomes for Adults with Stroke Disease. Healthcare. 2023;11:1803. https://doi.org/10.3390/healthcare11121803
16. Steffensen KD, Vinter M, Crüger D, Dankl K. Coulter A, Stuart B, et al. Lessons in integrating shared decision-making into cancer care. Journal of Oncology Practice. 2018;14:229–235. https://doi.org/10.1200/jop.18.00019
17. Hughes TM, Merath K, Chen Q, Sun S, Palmer E, Idrees J, et al. Association of shared decision-making on patient-reported health outcomes and healthcare utilization. American Journal of Surgery. 2018; 216: 7–12. https://doi.org/10.1016/j.amjsurg.2018.01.011
18. Søndergaard SR, Madsen PH, Hilberg O, Jensen KM, Olling K, Steffensen KD. A prospective cohort study of shared decision making in lung cancer diagnostics: impact of using a patient decision aid. Patient Educ. Couns. 2019; 102(11):1961–8. https://doi.org/10.1016/j.pec.2019.05.018
19. Metz MJ, Franz GC, Veerbeek MA, Beurs E, Van der Feltz-Cornelis CM, Beekman AT. Shared Decision Making in mental health care using Routine Outcome Monitoring as a source of information: a cluster randomised controlled trial. Study Protocol. BMC Psychiatry. 2015; 15:313. https://doi.org/10.1186/s12888-015-0696-2
20. Metz MJ, Veerbeek MA, Twisk WR, Van der Feltz-Cornelis CM, Beurs E, Beekman AT. Shared Decision Making in mental health care using Routine Outcome Monitoring as a source of information: a cluster randomised controlled trial. Original paper. Soc Pychiatry Psychiatr Epidemiol. 2019; 54(2):209-219. https://doi.org/10.1007/s00127-018-1589-8
21. Morata Barrado PC, Al-Raies Bolaños B, Blanco Cañibano E, López Espada C, Barreiro Veiguela J, Bellmunt Montoya S, Gil Sales J, Florit López S. Avanzando en la toma de decisiones compartida: estenosis carotídea asintomática. Angiología. 2019;71(5):190-193. http://dx.doi.org/10.20960/angiologia.00052
22. Pachi KS. Comunicación en el pase de guardia en las áreas de cuidados intensivos en el personal de enfermería. Salud, Ciencia y Tecnología 2022;2:60–60. https://doi.org/10.56294/saludcyt202260
23. Elwyn G, Frosch D, Volandes AE, et al. Investing in deliberation: A Definition and Classification of Decision Support Interventions for People Facing Difficult Health Decisions. Med Decis Making. 2010; 30(6):701-711. https://doi.org/10.1177/0272989X10386231
24. Amada LI, Burgos VS, Ferreyra M, Ibañez DBL, Lopez VE, Medina DZR, et al. Social construction of illness and disease. Community and Interculturality in Dialogue 2023;3:65–65. https://doi.org/10.56294/cid202365
25. Alonso Coello P, Álvarez Pérez Y, Blas Diez MP, Carlos Gil AM, Del Río D, Gaminde Inda I. Aplicación de las recomendaciones de las Guías de Práctica Clínica a la Toma de Decisiones Compartida. Ministerio de Sanidad: Instituto Aragonés de Ciencias de la Salud. 2022; Guías de Práctica Clínica en el SNS. https://portal.guiasalud.es/aplicacion-de-las-recomendaciones-de-las-guias-de-practica-clinica-a-la-toma-de-decisiones-compartida-manual-metodologico
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