Inconsistencies in patient perceptions and observer ratings of shared decision making: The case of colorectal cancer screening

Tracy Wunderlich, Gregory Cooper, George Divine, Sue Flocke, Nancy Oja-Tebbe, Kurt Stange, Jennifer Elston Lafata

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective: To compare patient-reported and observer-rated shared decision making (SDM) use for colorectal cancer (CRC) screening and evaluate patient, physician and patient-reported relational communication factors associated with patient-reported use of shared CRC screening decisions. Methods: Study physicians are salaried primary care providers. Patients are insured, aged 50-80 and due for CRC screening. Audio-recordings from 363 primary care visits were observer-coded for elements of SDM. A post-visit patient survey assessed patient-reported decision-making processes and relational communication during visit. Association of patient-reported SDM with observer-rated elements of SDM, as well as patient, physician and relational communication factors were evaluated using generalized estimating equations. Results: 70% of patients preferred SDM for preventive health decisions, 47% of patients reported use of a SDM process, and only one of the screening discussions included all four elements of SDM per observer ratings. Patient report of SDM use was not associated with observer-rated elements of SDM, but was significantly associated with female physician gender and patient-reported relational communication. Conclusion: Inconsistencies exist between patient reports and observer ratings of SDM for CRC screening. Practice implications: Future studies are needed to understand whether SDM that is patient-reported, observer-rated or both are associated with informed and value-concordant CRC screening decisions.

Original languageEnglish (US)
Pages (from-to)358-363
Number of pages6
JournalPatient Education and Counseling
Volume80
Issue number3
DOIs
StatePublished - Sep 1 2010
Externally publishedYes

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Early Detection of Cancer
Colorectal Neoplasms
Decision Making
Communication
Physicians
Primary Care Physicians
Primary Health Care

Keywords

  • Colorectal cancer
  • Observer report
  • Patient report
  • Relational communication
  • Shared decision making

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Inconsistencies in patient perceptions and observer ratings of shared decision making : The case of colorectal cancer screening. / Wunderlich, Tracy; Cooper, Gregory; Divine, George; Flocke, Sue; Oja-Tebbe, Nancy; Stange, Kurt; Lafata, Jennifer Elston.

In: Patient Education and Counseling, Vol. 80, No. 3, 01.09.2010, p. 358-363.

Research output: Contribution to journalArticle

Wunderlich, Tracy ; Cooper, Gregory ; Divine, George ; Flocke, Sue ; Oja-Tebbe, Nancy ; Stange, Kurt ; Lafata, Jennifer Elston. / Inconsistencies in patient perceptions and observer ratings of shared decision making : The case of colorectal cancer screening. In: Patient Education and Counseling. 2010 ; Vol. 80, No. 3. pp. 358-363.
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