Shared Decision Making in Clinical Practice
Experiences and Needs of Patients with Limited Health Literacy
Keywords:communication, shared decision making, limited health literacy, patients, focus group study
Shared Decision Making (SDM), currently considered a preferred model for making decisions in healthcare, requires that patients have the knowledge and skills to actively participate in the consultation and decision-making process. Patients with limited health literacy (LHL) often fail to do so. To gain insight into the experiences, needs and support for LHL-patients concerning SDM in clinical practice, five focus groups were held with 26 patients with LHL. A focus group discussion guide was developed based on 4-steps SDM models. Data was coded using thematic content analyses. LHL patients participating in this study had little experience with SDM in practice, but do prefer it. Important barriers for this are healthcare provider-related (involving patients too little in decision-making, using medical jargon), patient-related (feeling insecure to play a role in decision-making, inability to understand their diagnosis or information about treatment options), patient-provider interaction-related (relationship of trust) or system-related (too little consultation time). For SDM to take place more often, a shared responsibility between patients and healthcare providers is required. We recommend expanding the SDM models, by adding a step zero (patients understand their diagnosis) and a fifth step (reviewing the decision), to improve the process for LHL patients.
How to Cite
Copyright (c) 2022 Janneke Noordman, Mariska Oosterveld-Vlug, Jany Rademakers
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors agree to the following license and copyright agreement:
a. Authors retain copyright in their work.
b. Authors grant the European Journal of Health Communication the right of first publication online on the internet (on the publication platform HOPE of the Main Library of the University of Zurich).
c. The electronic contributions on the internet are distributed under the „Creative Commons Attribution 4.0 International“- License (CC BY 4.0). This license allows others to copy and redistribute the work in any medium or format, to remix, transform and build upon the material with an acknowledgement of the work's authorship and initial publication in the European Journal of Health Communication . These conditions are irrevocable. The full text of the license may be read under http://creativecommons.org/licenses/by/4.0/.
d. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of their work, as long as the conditions of the CC BY 4.0 License are fulfilled and initial publication in the European Journal of Health Communication is acknowledged.
e. Authors grant the Editors commercial rights, using a publishing house, to produce hardcopy volumes of the journal for sale to libraries and individuals, as well as to integrate the manuscript, its title, and its abstract in databases, abstracting and indexing services, and other similar information services.
f. This agreement is subject to possible legal disclosure obligations.
g. This agreement is governed by Swiss law. Court of jurisdiction is Zürich.