Shared Decision Making Clinical Trial
Official title:
Shared Decision Making in Physical Therapy: a Cross-sectional Observational Study
Shared decision making (SDM) is increasingly recommended in health care and reduces the
unbalanced power between physical therapists and patients. There is an increased focus on
communication between physical therapists and their patients during the goal setting process
in current research. This study will focus on SDM in physical therapy goal setting.
The SDM Process includes a problem definition and different goal options. Good communication
between physical therapists and patients during the goal setting process with an explicit
agreeing on both sides regarding treatment goals and options improves patient satisfaction,
treatment adherence and health outcomes.
Patients generally prefer to be actively involved in the shared decision making process.
However, the preferred level of involvement of patients regarding decisions differs.
Therefore, physical therapist should consider about patients' preferred level of involvement
in shared decision making. Previous research observed SDM behaviours of physical therapists
only in private practice settings. Research in other settings like the rehabilitation setting
are recommended. It is unknown whether there are differences between settings in the SDM
behaviours of physical therapists during first consultation.
Background
Shared decision making (SDM) is increasingly recommended in health care and reduces the
unbalanced power between physical therapists and patients. There is an increased focus on
communication between physical therapists and their patients during the goal setting process
in current research. This study will focus on SDM in physical therapy goal setting.
The SDM Process includes a problem definition and different goal options. Therefore, SDM may
be especially important during the goal setting process in the first consultation, where a
problem definition and several goal options are of interest.
An increased involvement of patients in SDM is based on clear information, empathy, two-way
communication and respect for patients' beliefs and concerns. Therefore, patients are more
willing to reveal information. Good communication between physical therapists and patients
during the goal setting process with an explicit agreeing on both sides regarding treatment
goals and options improves patient satisfaction, treatment adherence and health outcomes.
During the shared goal setting several topics should be discussed including patient's
expectations and concerns, different possible goals and their pros and cons. The quality of
this communication during the goal setting process can be evaluated by the OPTION Scale.
Patients generally prefer to be actively involved in the shared decision making process.
Previous research observed SDM behaviours of physical therapists, the patient's preferred
level of involvement and the agreement between the patient's preferred level of involvement
and the physical therapists' perception of the patient's preference during different therapy
consultations in private practice settings.
Communication between physical therapists and patients may be affected by patient's
self-efficacy and educational background and physical therapist's education and working
experiences. These factors will therefore be evaluated in the planned study. In addition,
therapists should consider patients individual preferences regarding their preferred level of
involvement in the goal setting process. The control preference scale measures patients'
preferred level of involvement and physical therapists' perception of this level.
It is unknown whether there are differences between settings in the SDM behaviours of
physical therapists. SDM may be different in rehabilitation and private practice settings. As
in private practice one physical therapist is treating the patient, there are several
physical therapists treating the patient in rehabilitation setting.
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