EoE Module 11 References-Makoul et al Patient Educ Couns 2006 An integrative model of shared decision making in medical encounters

Makoul et al Patient Educ Couns 2006 An integrative model of shared decision making in medical encounters

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The article by Gregory Makoul and Marla L. Clayman explores the concept of shared decision making (SDM) in medical encounters. The authors conducted a rigorous review of literature to understand the varied definitions and elements associated with SDM. They identified 418 articles on the subject, with 161 containing a conceptual definition. The review highlights the inconsistency and lack of a unified definition for SDM, which poses challenges in teaching, assessment, and research practices.<br /><br />The study identifies that "patient values/preferences" and "options" are the most frequently mentioned concepts in existing definitions, appearing in more than half of the formulations. Despite this, there remains a broad spread of 31 distinct concepts used to define SDM, indicating that no single definition or model has been universally accepted.<br /><br />In response, the authors propose an integrative model of SDM that consolidates existing literature and distinguishes between essential and ideal elements. Essential elements, deemed necessary for the process of SDM, include defining the problem, presenting options, discussing pros and cons, understanding patient values and preferences, and the ability of the patient to follow through with decisions. Ideal elements, which enhance but are not essential to SDM, involve the use of unbiased information and achieving mutual agreement.<br /><br />The researchers emphasize that while shared decision making aims to balance the roles of patients and doctors, practical implementations may vary in how equally the decision making is distributed. They stress that more consistent definitions could enhance the study of SDM and its impact on health outcomes.<br /><br />Ultimately, this integrative definition aims to facilitate further research and application of SDM in both complex and everyday clinical scenarios, contributing to improved provider-patient relationships and decision-making processes in healthcare settings.

Keywords

shared decision making

SDM

medical encounters

patient values

options

integrative model

essential elements

ideal elements

provider-patient relationships

healthcare