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 language | English (US) |
|---|---|
| Pages (from-to) | 358-363 |
| Number of pages | 6 |
| Journal | Patient Education and Counseling |
| Volume | 80 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 1 2010 |
| Externally published | Yes |
Fingerprint
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 journal › Article
}
TY - JOUR
T1 - Inconsistencies in patient perceptions and observer ratings of shared decision making
T2 - The case of colorectal cancer screening
AU - Wunderlich, Tracy
AU - Cooper, Gregory
AU - Divine, George
AU - Flocke, Sue
AU - Oja-Tebbe, Nancy
AU - Stange, Kurt
AU - Lafata, Jennifer Elston
PY - 2010/9/1
Y1 - 2010/9/1
N2 - 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.
AB - 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.
KW - Colorectal cancer
KW - Observer report
KW - Patient report
KW - Relational communication
KW - Shared decision making
UR - http://www.scopus.com/inward/record.url?scp=77955664822&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955664822&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2010.06.034
DO - 10.1016/j.pec.2010.06.034
M3 - Article
VL - 80
SP - 358
EP - 363
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 3
ER -