Reflecting on shared decision making: A reflection‐quantification study
Abstract Background Reflecting (“stop‐and‐think”) before rating may help patients consider the quality of shared decision making (SDM) and mitigate ceiling/halo effects that limit the performance of self‐reported SDM measures. Methods We asked a diverse patient sample from the United States to refle...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-10-01
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| Series: | Health Expectations |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/hex.12953 |
| _version_ | 1818434316062949376 |
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| author | Marleen Kunneman Christina M. LaVecchia Naykky Singh Ospina Abd Moain Abu Dabrh Emma M. Behnken Patrick Wilson Megan E. Branda Ian G. Hargraves Kathleen J. Yost Richard M. Frankel Victor M. Montori |
| author_facet | Marleen Kunneman Christina M. LaVecchia Naykky Singh Ospina Abd Moain Abu Dabrh Emma M. Behnken Patrick Wilson Megan E. Branda Ian G. Hargraves Kathleen J. Yost Richard M. Frankel Victor M. Montori |
| author_sort | Marleen Kunneman |
| collection | DOAJ |
| description | Abstract Background Reflecting (“stop‐and‐think”) before rating may help patients consider the quality of shared decision making (SDM) and mitigate ceiling/halo effects that limit the performance of self‐reported SDM measures. Methods We asked a diverse patient sample from the United States to reflect on their care before completing the 3‐item CollaboRATE SDM measure. Study 1 focused on rephrasing CollaboRATE items to promote reflection before each item. Study 2 used 5 open‐ended questions (about what went well and what could be improved upon, signs that the clinician understood the patient's situation, how the situation will be addressed, and why this treatment plan makes sense) to invite reflection before using the whole scale. A linear analogue scale assessed the extent to which the plan of care made sense to the patient. Results In Study 1, 107 participants completed surveys (84% response rate), 43 (40%) rated a clinical decision of which 27 (63%) after responding to reflection questions. Adding reflection lowered CollaboRATE scores (“less” SDM) and reduced the proportion of patients giving maximum (ceiling) scores (not statistically significant). In Study 2, 103 of 212 responders (49%) fully completed the version containing reflection questions. Reflection did not significantly change the distribution of CollaboRATE scores or of top scores. Participants indicated high scores on the sense of their care plan (mean 9.7 out of 10, SD 0.79). This rating was weakly correlated with total CollaboRATE scores (rho = .4, P = .0001). Conclusion Reflection‐before‐quantification interventions may not improve the performance of patient‐reported measures of SDM with substantial ceiling/halo effects. |
| first_indexed | 2024-12-14T16:35:03Z |
| format | Article |
| id | doaj.art-0550f2932db747fdb3ef977910cb00fa |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-12-14T16:35:03Z |
| publishDate | 2019-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-0550f2932db747fdb3ef977910cb00fa2022-12-21T22:54:29ZengWileyHealth Expectations1369-65131369-76252019-10-012251165117210.1111/hex.12953Reflecting on shared decision making: A reflection‐quantification studyMarleen Kunneman0Christina M. LaVecchia1Naykky Singh Ospina2Abd Moain Abu Dabrh3Emma M. Behnken4Patrick Wilson5Megan E. Branda6Ian G. Hargraves7Kathleen J. Yost8Richard M. Frankel9Victor M. Montori10Knowledge and Evaluation Research (KER) Unit Mayo Clinic Rochester MinnesotaKnowledge and Evaluation Research (KER) Unit Mayo Clinic Rochester MinnesotaDivision of Endocrinology, Department of Medicine University of Florida Gainesville FloridaDepartment of Family Medicine Mayo Clinic Jacksonville FloridaKnowledge and Evaluation Research (KER) Unit Mayo Clinic Rochester MinnesotaDivision of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic College of Medicine Rochester MinnesotaKnowledge and Evaluation Research (KER) Unit Mayo Clinic Rochester MinnesotaKnowledge and Evaluation Research (KER) Unit Mayo Clinic Rochester MinnesotaDivision of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic College of Medicine Rochester MinnesotaIndiana University School of Medicine Indianapolis IndianaKnowledge and Evaluation Research (KER) Unit Mayo Clinic Rochester MinnesotaAbstract Background Reflecting (“stop‐and‐think”) before rating may help patients consider the quality of shared decision making (SDM) and mitigate ceiling/halo effects that limit the performance of self‐reported SDM measures. Methods We asked a diverse patient sample from the United States to reflect on their care before completing the 3‐item CollaboRATE SDM measure. Study 1 focused on rephrasing CollaboRATE items to promote reflection before each item. Study 2 used 5 open‐ended questions (about what went well and what could be improved upon, signs that the clinician understood the patient's situation, how the situation will be addressed, and why this treatment plan makes sense) to invite reflection before using the whole scale. A linear analogue scale assessed the extent to which the plan of care made sense to the patient. Results In Study 1, 107 participants completed surveys (84% response rate), 43 (40%) rated a clinical decision of which 27 (63%) after responding to reflection questions. Adding reflection lowered CollaboRATE scores (“less” SDM) and reduced the proportion of patients giving maximum (ceiling) scores (not statistically significant). In Study 2, 103 of 212 responders (49%) fully completed the version containing reflection questions. Reflection did not significantly change the distribution of CollaboRATE scores or of top scores. Participants indicated high scores on the sense of their care plan (mean 9.7 out of 10, SD 0.79). This rating was weakly correlated with total CollaboRATE scores (rho = .4, P = .0001). Conclusion Reflection‐before‐quantification interventions may not improve the performance of patient‐reported measures of SDM with substantial ceiling/halo effects.https://doi.org/10.1111/hex.12953argumentationcommunicationmeasurementpatient involvementshared decision making |
| spellingShingle | Marleen Kunneman Christina M. LaVecchia Naykky Singh Ospina Abd Moain Abu Dabrh Emma M. Behnken Patrick Wilson Megan E. Branda Ian G. Hargraves Kathleen J. Yost Richard M. Frankel Victor M. Montori Reflecting on shared decision making: A reflection‐quantification study Health Expectations argumentation communication measurement patient involvement shared decision making |
| title | Reflecting on shared decision making: A reflection‐quantification study |
| title_full | Reflecting on shared decision making: A reflection‐quantification study |
| title_fullStr | Reflecting on shared decision making: A reflection‐quantification study |
| title_full_unstemmed | Reflecting on shared decision making: A reflection‐quantification study |
| title_short | Reflecting on shared decision making: A reflection‐quantification study |
| title_sort | reflecting on shared decision making a reflection quantification study |
| topic | argumentation communication measurement patient involvement shared decision making |
| url | https://doi.org/10.1111/hex.12953 |
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