Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 10;7(2):e013272.
doi: 10.1136/bmjopen-2016-013272.

What are the decision-making preferences of patients in vascular surgery? A mixed-methods study

T B Katrien Santema  1 , E Anniek Stoffer  2 , Marleen Kunneman  2 , Mark J W Koelemay  1 , Dirk T Ubbink  1
Affiliations

What are the decision-making preferences of patients in vascular surgery? A mixed-methods study

T B Katrien Santema et al. BMJ Open. .

Abstract

Objectives: Shared decision-making (SDM) has been advocated as the preferred method of choosing a suitable treatment option. However, patient involvement in treatment decision-making is not yet common practice in the field of vascular surgery. The aim of this mixed-methods study was to explore patients' decision-making preferences and to investigate which facilitators and barriers patients perceive as important for the application of SDM in vascular surgery.

Design and setting: Patients were invited to participate after visiting the vascular surgical outpatient clinic of an Academic Medical Center in the Netherlands. A treatment decision was made during the consultation for an abdominal aortic aneurysm or peripheral arterial occlusive disease. Patients filled in a number of questionnaires (quantitative part) and a random subgroup of patients participated in an in-depth interview (qualitative part).

Results: A total of 67 patients participated in this study. 58 per cent of them (n=39) indicated that they preferred a shared role in decision-making. In more than half of the patients (55%; n=37) their preferred role was in disagreement with what they had experienced. 31 per cent of the patients (n=21) preferred a more active role in the decision-making process than they had experienced. Patients indicated a good patient-doctor relationship as an important facilitator for the application of SDM.

Conclusions: The vast majority of vascular surgical patients preferred, but did not experience a shared role in the decision-making process, although the concept of SDM was insufficiently clear to some patients. This emphasises the importance of explaining the concept of SDM and implementing it in the clinical encounter.

Keywords: patient preferences; patient-involvement; shared decision-making.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Patients’ preferred and experienced role in decision-making.
See this image and copyright information in PMC

References

    1. Stiggelbout AM, Van der Weijden T, De Wit MP et al. . Shared decision making: really putting patients at the centre of healthcare. BMJ 2012;344:e256 10.1136/bmj.e256 - DOI - PubMed
    1. Elwyn G, Frosch D, Thomson R et al. . Shared decision making: a model for clinical practice. J Gen Intern Med 2012;27:1361–7. 10.1007/s11606-012-2077-6 - DOI - PMC - PubMed
    1. Elwyn G, Laitner S, Coulter A et al. . Implementing shared decision making in the NHS. BMJ 2010;341:c5146 10.1136/bmj.c5146 - DOI - PubMed
    1. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Social Sci Med 1997;44:681–92. - PubMed
    1. Coulter A. Partnerships with patients: the pros and cons of shared clinical decision making. J Health Serv Res Policy 1997;2:112–21. - PubMed

LinkOut - more resources