title: Understanding patient perceptions of shared decision making.
abstract: OBJECTIVE
  This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared.
  
  
  METHODS
  Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis.
  
  
  RESULTS
  Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision.
  
  
  CONCLUSIONS
  There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of "agreement" may be more important than the actual decision-making process for patients to label a decision as shared.
  
  
  CONCLUSIONS
  Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM.
authors.affiliation: Center for Health Promotions and Research, University of Texas School of Public Health, San Antonio, USA. Electronic address: Laura.Aubree.Shay@uth.tmc.edu.
authors.forename: L Aubree
authors.initials: LA
authors.lastname: Shay
authors.affiliation: Massey Cancer Center and Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, USA.
authors.forename: Jennifer Elston
authors.initials: JE
authors.lastname: Lafata
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010358:Patient Participation; D010465:Perception; D010819:Physician's Role; D010817:Physician-Patient Relations; D011320:Primary Health Care; D036301:Qualitative Research; D035502:Trust
keywords: Patient perceptions; Primary care decision-making; Qualitative interviews; Shared decision making
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