Deconstructing patient centred communication and uncovering shared decision making: an observational study.
BACKGROUND
Patient centred communication (PCC) has been described as a method for doctor-patient communication. The principles of shared decision making (SDM) have been proposed more recently.


OBJECTIVE
This study aimed to examine PCC and SDM empirically with respect to their mutual association, the variation in practitioners' working styles, and the associations with patient characteristics.


METHODS
Sixty general practitioners recruited 596 adult patients who gave written consent to have their consultations videotaped. The tapes were assessed by two researchers, using a standardised instrument for global communication. For the purpose of this exploratory study, scales for PCC and SDM were based on subsamples of items in the MAAS.


RESULTS
The scales for PCC and SDM were weakly associated (Pearson correlation: 0.25). Physicians varied more on SDM than on PCC. The intracluster correlation of the PCC and SDM scales were, respectively, 0.34 and 0.19. However, hypotheses regarding associations with patient characteristics were not confirmed. Neither PCC nor SDM scores were related to patient gender, education, age, functional health status or existence of chronic conditions.


CONCLUSIONS
The study provides evidence that PCC and SDM can be differentiated and comprise approaches to communication between clinicians and patients which may be more clearly distinguished by further focused research and training developments.
Wensing
Michel
M
Centre for Quality of Care Research, University Medical Centre Nijmegen, P,O, Box 9101, 6500 HB, Nijmegen, The Netherlands. M.Wensing@hsv.kun.nl
Elwyn
Glyn
G
Edwards
Adrian
A
Vingerhoets
Eric
E
Grol
Richard
R
D000328:Adult; D000368:Aged; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D019370:Observation / Q000379:methods; D010358:Patient Participation; D010817:Physician-Patient Relations