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Please use this identifier to cite or link to this item: http://hdl.handle.net/2164/185

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Title: Involvement in treatment decision making : its meaning to people with diabetes and implications for conceptualisation
Authors: Entwistle, Vikki
Prior, Maria
Skea, Zoe Christina
Francis, Jillian Joy
University of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
Keywords: Decision Making
Patient Participation
Issue Date: 23-Oct-2007
Publisher: Elsevier
Citation: Entwistle, V., Prior, M., Skea, Z.C., and Francis, J.J. (2007). Involvement in treatment decision making : its meaning to people with diabetes and implications for conceptualisation. Social Science & Medicine, 66(2), pp. 362-375.
Abstract: Patient involvement in decision-making is widely regarded as an important feature of good-quality healthcare. Policy-makers have been particularly concerned to ensure that patients are informed about and enabled to choose between relevant treatment options, but it is not clear how patients understand and value involvement. We investigated the meaning of involvement in treatment decision-making for people with diabetes. We conducted semi-structured interviews with 18 people aged between 20 and 79 who had type 1 or type 2 diabetes selected from 4 multi-practitioner outpatient clinics in the Grampian area of Scotland. We used several strategies to probe their understandings of involvement, including a discussion of how they would respond to a question about involvement in treatment decisions that appears on the National Patient Survey used to monitor the quality of healthcare in England. Participants associated involvement in decision-making with a number of features relating to the ethos and feel of healthcare encounters (welcoming; respectful; facilitative of patients’ contributions; and non-judgemental); communication about health problems (practitioners attending to patients’ views and patients feeling listened to; practitioners giving clear explanations based on their professional knowledge and patients understanding these); and communication about treatments (practitioners explaining treatment rationales in ways that patients understand and enabling patients to feel they have a say). Our findings have implications for practical attempts to involve patients in decisions about their care and for the conceptualisation and assessment of patient involvement. They suggest that practitioners who aspire to facilitate patient involvement should attend to the ethos they foster in consultations and the way they discuss problems as well as to the provision of information about treatment options and the scope patients have to influence decisions. Models and taxonomies of patient involvement in decision-making need to be developed to accommodate both problem-solving phases and the relational and subjective dimensions of involvement.
URI: http://hdl.handle.net/2164/185
DOI: http://dx.doi.org/10.1016/j.socscimed.2007.09.001
ISSN: 0277-9536
Appears in Collections:Applied Health Sciences research
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