Abstract
BackgroundPatient centred communication (PCC) has been described as a method for doctor-patient communication. The principles of shared decision making (SDM) have been proposed more recently.AimsThis study aimed to examine PCC and SDM empirically with respect to their mutual association, the variation in practitioners' working styles, and the associations with patient characteristics.MethodsSixty general practitioners recruited 596 adult patients who gave written consent to have their consultations videotaped. The tapes were assessed by two researchers, using a standardised instrument for global communication. For the purpose of this exploratory study, scales for PCC and SDM were based on subsamples of items in the MAAS.ResultsThe scales for PCC and SDM were weakly associated (Pearson correlation: 0.25). Physicians varied more on SDM than on PCC. The intracluster correlation of the PCC and SDM scales were, respectively, 0.34 and 0.19. However, hypotheses regarding associations with patient characteristics were not confirmed. Neither PCC nor SDM scores were related to patient gender, education, age, functional health status or existence of chronic conditions.ConclusionThe study provides evidence that PCC and SDM can be differentiated and comprise approaches to communication between clinicians and patients which may be more clearly distinguished by further focused research and training developments.
Highlights
Patient centred communication (PCC) has been described as a method for doctorpatient communication
The study provides evidence that PCC and shared decision making (SDM) can be differentiated and comprise approaches to communication between clinicians and patients which may be more clearly distinguished by further focused research and training developments
Shared decision making has been introduced as a proposed middle ground between paternalistic decision-making and what has been termed 'informed' or 'consumer' choice where decisional responsibility is placed with patients [3]
Summary
Patient centred communication (PCC) has been described as a method for doctorpatient communication. The principles of shared decision making (SDM) have been proposed more recently. This study examines the concepts of shared decision making (SDM) and the patient centred communication method (PCC). Stewart et al described PCC as a clinical method with six key components: exploring both the disease and the illness experience, understanding the whole person, finding common ground, incorporating prevention and health promotion, enhancing the doctor-patient relationship, and being realistic [1]. The principles of shared decision making can be located within the 'identification of common ground regarding management' component of PCC. It implies participation of both the patient and the clinician in the decision-making process, and it includes different aspects such as listing and provision of information on treatment options, checking of patients' understanding and preferences for involvement in decision making [4]. We explored whether PCC and SDM are different concepts
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