Landetal-2017
| Landetal-2017 | |
|---|---|
| BibType | ARTICLE |
| Key | Land2017 |
| Author(s) | Victoria Land, Ruth Parry, Jane Seymour |
| Title | Communication practices that encourage and constrain shared decision-making in healthcare encounters: Systematic review of conversation analytic research |
| Editor(s) | |
| Tag(s) | EMCA, Shared decision-making, Patient Participation, Patient choice, Medical interaction |
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| Year | 2017 |
| Language | English |
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| Month | |
| Journal | Health Expectations |
| Volume | 20 |
| Number | 6 |
| Pages | 1228–1247 |
| URL | Link |
| DOI | 10.1111/hex.12557 |
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Abstract
Background:
Shared decision making (SDM) is generally treated as good practice in healthcare interactions. Conversation analytic research has yielded detailed findings about decision making in healthcare encounters.
Objective:
To map decision making communication practices relevant to healthcare outcomes in face-to-face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM.
Search strategy:
We searched nine electronic databases (last search November 2016) and our own and other academics’ collections.
Inclusion criteria:
Published conversation analyses (no restriction on publication dates) using recordings of healthcare encounters in English where the patient (and/or companion) was present and where the data and analysis focused on health/illness-related decision making.
Data extraction and synthesis:
We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively.
Results:
Twenty-eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organised these in relation to four elements of decision making sequences: (1) broaching decision making; (2) putting forward a course of action; (3) committing or not (to the action put forward); and (4) HCPs’ responses to patients’ resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs’ practices may constrain or encourage this participation.
Conclusions:
Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non-negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (e.g. by bringing the patient towards shared understanding of the decision’s rationale).
Notes
