Dyadic OPTION: Measuring perceptions of shared decision-making in practice.
BACKGROUND
Current models of the medical consultation emphasize shared decision-making (SDM), whereby the expertise of both the doctor and the patient are recognised and seen to equally contribute to the consultation. The evidence regarding the desirability and effectiveness of the SDM approach is often conflicting. It is proposed that the conflicts are due to the nature of assessment, with current assessments from the perspective of an outside observer.


OBJECTIVE
To empirically assess perceived involvement in the medical consultation using the dyadic OPTION instrument.


METHODS
36 simulated medical consultations were organised between general practitioners and standardized- patients, using the observer OPTION and the newly developed dyadic OPTION instruments.


RESULTS
SDM behaviours observed in the consultations were seen to depend on both members of the doctor and patient dyad, rather than each in isolation. Thus a dyadic approach to measurement is supported.


CONCLUSIONS
This current study highlights the necessity for a dyadic approach to assessment and introduces a novel research instrument: the dyadic OPTION instrument.
Department of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS.
Emma
E
Melbourne
Stephen
S
Roberts
Marie-Anne
MA
Durand
Robert
R
Newcombe
France
F
Légaré
Glyn
G
Elwyn
D000293:Adolescent; D003142:Communication; D003657:Decision Making; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D010358:Patient Participation; D017060:Patient Satisfaction; D016544:Patient Simulation; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010820:Physicians; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013637:Tape Recording; D055815:Young Adult