Option Grids: Shared decision making made easier

被引:215
作者
Elwyn, Glyn [1 ,3 ]
Lloyd, Amy [1 ]
Joseph-Williams, Natalie [1 ]
Cording, Emma [1 ]
Thomson, Richard [2 ]
Durand, Marie-Anne [3 ,4 ]
Edwards, Adrian [1 ]
机构
[1] Cardiff Univ, Sch Med, Inst Primary Care & Publ Hlth, Cardiff CF14 4YS, Wales
[2] Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[3] Dartmouth Coll, Dartmouth Ctr Hlth Care Delivery Sci, Hanover, NH 03755 USA
[4] Univ Hertfordshire, Sch Psychol, Hatfield AL10 9AB, Herts, England
关键词
Shared decision making; Communication skills; Patient involvement; Decision making; Patient centered care; RANDOMIZED-TRIAL; IMPLEMENTATION; COMMUNICATION; DIFFICULT; SURGERY; DESIGN; POLICY; AIDS;
D O I
10.1016/j.pec.2012.06.036
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: To describe the exploratory use of short decision support tools for patients, called Option Grids. Option Grids are summary tables, using one side of paper to enable rapid comparisons of options, using questions that patients frequently ask (FAQs) and designed for face-to-face clinical encounters. To date, most evidence about 'patient decision aids' has been based on tools with high content levels, designed for patients to use independently, either before or after visits. Methods: We studied the use of Option Grids in a quality improvement project, collecting field notes and conducting interviews with clinical teams. Results: In the 'Making Good Decisions in Collaboration' (MAGIC) program, clinicians found that using Option Grids made it easier to explain the existence of options and reported a 'handover' effect, where patient involvement in decision making was enhanced. Conclusion: Option Grids made options more visible and clinicians found it easier to undertake shared decision making when these tools were available. Used in a collaborative way, they enhance patients' confidence and voice, increasing their involvement in collaborative dialogs. Practice implications: Further work to confirm these preliminary findings is required, to measure processes and to assess whether these tools have similar impact in other clinical settings. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:207 / 212
页数:6
相关论文
共 26 条
[1]  
[Anonymous], IMPL PROGR
[2]  
[Anonymous], J GEN INTERN MED
[3]  
[Anonymous], 2010, EQ EXC LIB NHS
[4]   The design of a decision aid about diabetes medications for use during the consultation with patients with type 2 diabetes [J].
Breslin, Maggie ;
Mlillan, Rebecca J. ;
Montori, Victor M. .
PATIENT EDUCATION AND COUNSELING, 2008, 73 (03) :465-472
[5]   Clinicians' concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision-making [J].
Caldon, Lisa J. M. ;
Collins, Karen A. ;
Reed, Malcolm W. ;
Sivell, Stephanie ;
Austoker, Joan ;
Clements, Alison M. ;
Patnick, Julietta ;
Elwyn, Glyn .
HEALTH EXPECTATIONS, 2011, 14 (02) :133-146
[6]  
Davis Ruth E, 2003, Health Expect, V6, P198, DOI 10.1046/j.1369-6513.2003.00235.x
[7]   Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice [J].
Elwyn, G ;
Edwards, A ;
Hood, K ;
Robling, M ;
Atwell, C ;
Russell, I ;
Wensing, M ;
Grol, R .
FAMILY PRACTICE, 2004, 21 (04) :337-346
[8]   Investing in Deliberation: A Definition and Classification of Decision Support Interventions for People Facing Difficult Health Decisions [J].
Elwyn, Glyn ;
Frosch, Dominick ;
Volandes, Angelo E. ;
Edwards, Adrian ;
Montori, Victor M. .
MEDICAL DECISION MAKING, 2010, 30 (06) :701-711
[9]   Arduous implementation: Does the Normalisation Process Model explain why it's so difficult to embed decision support technologies for patients in routine clinical practice [J].
Elwyn, Glyn ;
Legare, France ;
van der Weijden, Trudy ;
Edwards, Adrian ;
May, Carl .
IMPLEMENTATION SCIENCE, 2008, 3 (1)
[10]   Shared decision making in the United States: policy and implementation activity on multiple fronts [J].
Frosch, Dominick L. ;
Moulton, Benjamin W. ;
Wexler, Richard M. ;
Holmes-Rovner, Margaret ;
Volk, Robert J. ;
Levin, Carrie A. .
ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN, 2011, 105 (04) :305-312