Occupational therapists’ shared decision-making behaviors with patients having persistent pain in a work rehabilitation context: A cross-sectional study

Abstract

In a work rehabilitation context, we assessed occupational therapists’ (OTs) shared decision-making (SDM) behaviors with individuals having persistent pain and explored factors influencing SDM behaviors. A cross-sectional study that used audio-recordings of work rehabilitation consultations between OTs trained in SDM and a convenient sample of patients. Eligible patients were: off work for ≥ 12 weeks due to persistent pain associated with a musculoskeletal disorder, starting a work rehabilitation program, and French speaking. Transcripts were analyzed using the Observing Patient Involvement in Shared Decision-Making (OPTION) instrument and assessed patients’ decisional conflict and socioeconomic status. Of 15 OTs trained in SDM, 11 (90% female), provided audiotaped SDM meetings with 37 patients (40.5% female; aged 18–62 years). Their average OPTION score was 53.94 out of 100 (SD = 9.68; range: 35.42–70.83), indicating basic skills. Significant factors associated with OPTION scores ( R 2 adjusted = 21.7%) were the interview length ( P = .008) and level of patient education ( P = .038). Basic SDM behaviors were integrated in the practice of OTs trained in SDM. Evaluating SDM behaviors is a step toward providing OTs with performance feedback toward achieving client-centered care.