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To what extent do existing measures of shared decision-making incorporate assessment of deliberation by the patient?

Southall, Sara 2016. To what extent do existing measures of shared decision-making incorporate assessment of deliberation by the patient? MPhil Thesis, Cardiff University.
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Abstract

To research and develop robust, effective shared-decision support requires a clear definition of the decision-making process. Elwyn and Miron-Shatz have developed a model incorporating deliberation, but it is uncertain the extent this proposed decision process is addressed in existing measures of decisionmaking. This review aims to ystematically identify and analyse measures considering the process from the patient’s perspective, determining the extent items cover a decision process model incorporating deliberation. Method A systematic and robust search strategy was developed to identify studies reporting the development and psychometric evaluation of an instrument measuring shared decision-making in the health-care setting, specifically from the patient’s perspective of the decision making process. The search strategy incorporated seven electronic databases supplemented by manual searches. As well as descriptive details of the study, scales were mapped against the decision process model, and the methodological quality of study design and the adequacy of instrument measurement properties were appraised using reproducible standards. Results Of the 7,563 references identified, ten studies involving the development of measures were included and an additional nine addressed the further evaluation of instruments. The methodological quality was highly variable, both between and within studies and none of the scales scored consistently well for measurement properties when compared with the criteria of adequacy. One scale was found to map against all stages of deliberation, but none addressed all stages of the decision process model. Conclusion The results indicate that current measures of decision-making do not considerall steps of the decision process proposed by Elwyn and Miron-Shatz. The Decision Making Quality Scale (DMQS), developed by Hollen and based on the work of Janis and Mann, addressed aspects of deliberation not covered by other measures. Recommendations for a new instrument specification include methodological improvement and consideration of the work of Janis and Mann

Item Type: Thesis (MPhil)
Date Type: Completion
Status: Unpublished
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Date of First Compliant Deposit: 27 September 2016
Last Modified: 28 Oct 2021 08:26
URI: https://orca.cardiff.ac.uk/id/eprint/94933

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