The potential for shared decision-making and decision aids in rehabilitation medicine.
OBJECTIVE
Shared decision-making and the use of decision aids are increasingly promoted in various healthcare settings. The extent of their current use and potential in rehabilitation medicine is unknown. The aim of the present study was to explore the barriers to and facilitators of shared decision-making and use of decision aids in daily practice, and to explore the perceptions of physical and rehabilitation medicine (PRM) physicians toward them.


METHODS
A cross-sectional survey of 408 PRM physicians was performed (response rate 31%).


RESULTS
PRM physicians expressed the highest levels of comfort with shared decision-making as opposed to paternalistic and informed decision-making. The majority reported that shared decision-making constituted their usual approach. The most important barriers to shared decision-making were cases in which the patient received conflicting recommendations and when the patient had difficulty accepting the disease. Key facilitators were the patient's trust in the PRM physician and the patient being knowledgeable about the disease and about treatment options. PRM physicians' attitudes towards the use of decision aids to inform patients were moderately positive.


CONCLUSIONS
Shared decision-making appears to have great potential in the rehabilitation setting. Increasing the use of decision aids may contribute to the further implementation of shared decision-making.
van Til
Janine A
JA
HTRS, University of Twente, Enschede, The Netherlands. j.a.vantil@utwente.nl
Drossaert
Constance H C
CH
Punter
R Annemiek
RA
Ijzerman
Maarten J
MJ
D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010358:Patient Participation; D017060:Patient Satisfaction; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D012046:Rehabilitation; D011795:Surveys and Questionnaires