TY - JOUR
T1 - What value structure underlies shared decision making?
T2 - A qualitative synthesis of models of shared decision making
AU - Oueslati, Roukayya
AU - Woudstra, Anke J.
AU - Alkirawan, Rima
AU - Reis, Ria
AU - van Zaalen, Yvonne
AU - Slager, Meralda T.
AU - Stiggelbout, Anne M.
AU - Touwen, Dorothea P.
N1 - Publisher Copyright: © 2024 The Authors
PY - 2024/7
Y1 - 2024/7
N2 - 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 healthcare professionals' (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, and HCPs when practicing.
AB - 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 healthcare professionals' (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, and HCPs when practicing.
UR - http://www.scopus.com/inward/record.url?scp=85189697378&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2024.108284
DO - 10.1016/j.pec.2024.108284
M3 - Review article
C2 - 38583353
AN - SCOPUS:85189697378
SN - 0738-3991
VL - 124
JO - Patient Education and Counseling
JF - Patient Education and Counseling
M1 - 108284
ER -