What value structure underlies shared decision making? A qualitative synthesis of models of shared decision making
Patient Education and Counseling(2024)
摘要
Objective
To construct the underlying value structure of shared decision making (SDM) models.
Method
We included previously identified SDM-models (n=40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz’s value theory to define values in SDM and to investigate value relations.
Results
We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of HCPs’ and patients’ skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients’ autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism].
Conclusion
SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients’ Self-Direction.
Practice implications
This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients’ values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs for SDM, and HCPs when practicing.
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关键词
Shared decision making,Scoping review,Values,Thematic analysis,Qualitative synthesis,Normativity,Vulnerable populations
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