IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v329y2023ics027795362300326x.html
   My bibliography  Save this article

Shared decision-making during prostate cancer consultations: Implications of clinician misalignment with patient and partner preferences

Author

Listed:
  • Stewart, Simon John
  • Roberts, Lisa
  • Brindle, Lucy

Abstract

Concepts of patient-centredness and shared decision-making inform expectations that clinicians should display sensitivity to patients' expressed preferences. This study examines the organisation of treatment-related preferences expressed by patients and their partners during clinical consultations for people with localised prostate cancer. A conversation analysis of twenty-eight diagnosis and treatment consultations was conducted with data recorded from four clinical sites across England. When clinicians disaligned from expressions of preference such as directing talk away from expressions, or moving to redress perceived misunderstandings, it caused discordance in the unfolding interaction. This led to couples silencing themselves. Two deviant cases were identified that did not feature the misalignment found in all other collected cases. In these two cases, the interaction remained collaborative. These findings highlight the immediate consequences of expressions of preference being resisted, rejected, and dismissed in a context where clinicians are expected to explore expressed preferences in service of SDM. The deviant case analysis offers an alternative practice to the pattern observed across the collection, offering a comparison between misaligned sequences, and cases where social solidarity was maintained. By acknowledging couple's expressions as valid contributions, rather than acting to inform or correct them, clinicians can create opportunity spaces for discussion around treatment preferences.

Suggested Citation

  • Stewart, Simon John & Roberts, Lisa & Brindle, Lucy, 2023. "Shared decision-making during prostate cancer consultations: Implications of clinician misalignment with patient and partner preferences," Social Science & Medicine, Elsevier, vol. 329(C).
  • Handle: RePEc:eee:socmed:v:329:y:2023:i:c:s027795362300326x
    DOI: 10.1016/j.socscimed.2023.115969
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S027795362300326X
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2023.115969?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    2. Wade, Julia & Donovan, Jenny L. & Athene Lane, J. & Neal, David E. & Hamdy, Freddie C., 2009. "It's not just what you say, it's also how you say it: Opening the 'black box' of informed consent appointments in randomised controlled trials," Social Science & Medicine, Elsevier, vol. 68(11), pages 2018-2028, June.
    3. Koenig, Christopher J., 2011. "Patient resistance as agency in treatment decisions," Social Science & Medicine, Elsevier, vol. 72(7), pages 1105-1114, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tate, Alexandra, 2020. "Invoking death: How oncologists discuss a deadly outcome," Social Science & Medicine, Elsevier, vol. 246(C).
    2. Landmark, Anne Marie Dalby & Svennevig, Jan & Gulbrandsen, Pål, 2016. "Negotiating treatment preferences: Physicians' formulations of patients' stance," Social Science & Medicine, Elsevier, vol. 149(C), pages 26-36.
    3. Manuel Antonio Espinoza & Andrea Manca & Karl Claxton & Mark Sculpher, 2018. "Social value and individual choice: The value of a choice‐based decision‐making process in a collectively funded health system," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 28-40, February.
    4. Hyojung Tak & Gregory Ruhnke & Ya-Chen Shih, 2015. "The Association between Patient-Centered Attributes of Care and Patient Satisfaction," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 187-197, April.
    5. Miller, Nancy & Weinstein, Marcie, 2007. "Participation and knowledge related to a nursing home admission decision among a working age population," Social Science & Medicine, Elsevier, vol. 64(2), pages 303-313, January.
    6. France Légaré & Annette M. O'Connor & Ian D. Graham & Georges A. Wells & Stéphane Tremblay, 2006. "Impact of the Ottawa Decision Support Framework on the Agreement and the Difference between Patients' and Physicians' Decisional Conflict," Medical Decision Making, , vol. 26(4), pages 373-390, July.
    7. Odette Wegwarth & Wolfgang Gaissmaier & Gerd Gigerenzer, 2011. "Deceiving Numbers," Medical Decision Making, , vol. 31(3), pages 386-394, May.
    8. Karnieli-Miller, Orit & Eisikovits, Zvi, 2009. "Physician as partner or salesman? Shared decision-making in real-time encounters," Social Science & Medicine, Elsevier, vol. 69(1), pages 1-8, July.
    9. Paul C. Schroy III & Karen Emmons & Ellen Peters & Julie T. Glick & Patricia A. Robinson & Maria A. Lydotes & Shamini Mylvanaman & Stephen Evans & Christine Chaisson & Michael Pignone & Marianne Prout, 2011. "The Impact of a Novel Computer-Based Decision Aid on Shared Decision Making for Colorectal Cancer Screening," Medical Decision Making, , vol. 31(1), pages 93-107, January.
    10. Mei-Chun Cheung & Derry Law & Joanne Yip & Jason Pui Yin Cheung, 2022. "Adolescents’ Experience during Brace Treatment for Scoliosis: A Qualitative Study," IJERPH, MDPI, vol. 19(17), pages 1-10, August.
    11. Meike Müller-Engelmann & Norbert Donner-Banzhoff & Heidi Keller & Lydia Rosinger & Carsten Sauer & Kerstin Rehfeldt & Tanja Krones, 2013. "When Decisions Should Be Shared," Medical Decision Making, , vol. 33(1), pages 37-47, January.
    12. Margaret Gerteis & Rosemary Borck, "undated". "Shared Decision-Making in Practice: Lessons from Implementation Efforts," Mathematica Policy Research Reports f802e52b8442486594ecda927, Mathematica Policy Research.
    13. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    14. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    15. Ruth Astbury & Ashley Shepherd & Helen Cheyne, 2017. "Working in partnership: the application of shared decision‐making to health visitor practice," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(1-2), pages 215-224, January.
    16. Vivek Goel & Carol A. Sawka & Elaine C. Thiel & Elaine H. Gort & Annette M. O’Connor, 2001. "Randomized Trial of a Patient Decision Aid for Choice of Surgical Treatment for Breast Cancer," Medical Decision Making, , vol. 21(1), pages 1-6, February.
    17. Solomon, Josie & Knapp, Peter & Raynor, D.K. & Atkin, Karl, 2013. "Worlds apart? An exploration of prescribing and medicine-taking decisions by patients, GPs and local policy makers," Health Policy, Elsevier, vol. 112(3), pages 264-272.
    18. Debra Kerr & Rosie Crone & Trisha Dunning, 2020. "Perspectives about dignity during acute care for older people and their relatives: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(21-22), pages 4116-4127, November.
    19. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2006. "Patient-doctor decision-making about treatment within the consultation--A critical analysis of models," Social Science & Medicine, Elsevier, vol. 62(1), pages 116-124, January.
    20. Bernardi, Roberta & Wu, Philip F., 2022. "Online health communities and the patient-doctor relationship: An institutional logics perspective," Social Science & Medicine, Elsevier, vol. 314(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:329:y:2023:i:c:s027795362300326x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.