Shared Decision Making in Physical Therapy: a Cross-sectional Observational Study

Shared Decision Making Clinical Trial

Official title:

Shared Decision Making in Physical Therapy: a Cross-sectional Observational Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03266796
• Other study ID #: Projekt ID: 2017-00848
• Status: Completed
• Phase: N/A
• First received: August 5, 2017
• Last updated: March 5, 2018
• Start date: September 1, 2017
• Est. completion date: March 5, 2018

Study information

• Verified date: March 2018
• Source: Klinik Valens
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 30
• Est. completion date: March 5, 2018
• Est. primary completion date: January 31, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

musculoskeletal disorders First treatment German speaking

Exclusion Criteria:

Related Conditions & MeSH terms

• Shared Decision Making

Intervention

Behavioral:
• goal setting process
goal setting process during the first consultation

Locations

Country	Name	City	State
Switzerland	Kliniken Valens	Valens

Sponsors (1)

Lead Sponsor	Collaborator
Klinik Valens

Country where clinical trial is conducted

Switzerland, 

References & Publications (17)

Beers E, Lee Nilsen M, Johnson JT. The Role of Patients: Shared Decision-Making. Otolaryngol Clin North Am. 2017 Aug;50(4):689-708. doi: 10.1016/j.otc.2017.03.006. Epub 2017 May 30. Review. — View Citation

Bertakis KD. The communication of information from physician to patient: a method for increasing patient retention and satisfaction. J Fam Pract. 1977 Aug;5(2):217-22. — View Citation

Brady TJ. The patient's role in rheumatology care. Curr Opin Rheumatol. 1998 Mar;10(2):146-51. Review. — View Citation

Burton D, Blundell N, Jones M, Fraser A, Elwyn G. Shared decision-making in cardiology: do patients want it and do doctors provide it? Patient Educ Couns. 2010 Aug;80(2):173-9. doi: 10.1016/j.pec.2009.10.013. Epub 2009 Nov 30. — View Citation

Chewning B, Bylund CL, Shah B, Arora NK, Gueguen JA, Makoul G. Patient preferences for shared decisions: a systematic review. Patient Educ Couns. 2012 Jan;86(1):9-18. doi: 10.1016/j.pec.2011.02.004. Epub 2011 Apr 6. Review. — View Citation

Degner LF, Sloan JA, Venkatesh P. The Control Preferences Scale. Can J Nurs Res. 1997 Fall;29(3):21-43. — View Citation

Dierckx K, Deveugele M, Roosen P, Devisch I. Implementation of shared decision making in physical therapy: observed level of involvement and patient preference. Phys Ther. 2013 Oct;93(10):1321-30. doi: 10.2522/ptj.20120286. Epub 2013 May 2. — View Citation

Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013 Jan 3;3(1). pii: e001570. doi: 10.1136/bmjopen-2012-001570. — View Citation

Duncan E, Best C, Hagen S. Shared decision making interventions for people with mental health conditions. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007297. doi: 10.1002/14651858.CD007297.pub2. Review. — View Citation

Durand MA, Yen R, Barr PJ, Cochran N, Aarts J, Légaré F, Reed M, James O'Malley A, Scalia P, Painchaud Guérard G, Elwyn G. Assessing medical student knowledge and attitudes about shared decision making across the curriculum: protocol for an international — View Citation

Elwyn G, Edwards A, Mowle S, Wensing M, Wilkinson C, Kinnersley P, Grol R. Measuring the involvement of patients in shared decision-making: a systematic review of instruments. Patient Educ Couns. 2001 Apr;43(1):5-22. Review. — View Citation

Elwyn G, Edwards A, Wensing M, Hood K, Atwell C, Grol R. Shared decision making: developing the OPTION scale for measuring patient involvement. Qual Saf Health Care. 2003 Apr;12(2):93-9. Review. — View Citation

Kaplan SH, Greenfield S, Ware JE Jr. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989 Mar;27(3 Suppl):S110-27. Erratum in: Med Care 1989 Jul;27(7):679. — View Citation

Loh A, Simon D, Wills CE, Kriston L, Niebling W, Härter M. The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial. Patient Educ Couns. 2007 Aug;67(3):324-32. Epub 2007 May 16. — View Citation

Luszczynska A, Scholz U, Schwarzer R. The general self-efficacy scale: multicultural validation studies. J Psychol. 2005 Sep;139(5):439-57. — View Citation

Roter DL, Hall JA, Merisca R, Nordstrom B, Cretin D, Svarstad B. Effectiveness of interventions to improve patient compliance: a meta-analysis. Med Care. 1998 Aug;36(8):1138-61. — View Citation

Weiss MC, Peters TJ. Measuring shared decision making in the consultation: a comparison of the OPTION and Informed Decision Making instruments. Patient Educ Couns. 2008 Jan;70(1):79-86. Epub 2007 Oct 17. — View Citation

* Note: There are 17 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	General Self-Efficacy Scale (GSE)	The General Self-Efficacy Scale (GSE) measures self-reported self-efficacy. The GSE is valid and Cronbach's alpha of internal reliability is between .76 and .90. Positive correlations to emotion, optimism, work satisfaction and negative correlations to depression, stress, health complaints, burnout and anxiety are examined. (Luszczynska et al., 2005) The GSE is potentially associated with SDM preference.	day 1 (e.g. "through study completion, an average of 1 year")
Other	Characteristics of patients and physical therapists	The following characteristics will be assessed because of their possible influence on SDM preferences.; Patients: age, sex, previous therapy for current problem, profession Physiotherapists: age, sex, work experiences in years, education	day 1 (e.g. "through study completion, an average of 1 year")
Primary	OPTION scale	The OPTION scale measures physical therapists behaviour in shared decision making. It is a measurement that evaluates the involvement of patients in shared decision making and was shown to be reliable (Elwyn et al., 2003). The OPTION scale includes items looking at communication between physical therapist and patient, especially an identified problem, patient's beliefs and concerns, different goal and treatment option and their pros and cons, patient's preferred level of involvement, possibilities for patient's to ask questions and a review of the physical therapist at the end.	day 1 (e.g. "through study completion, an average of 1 year")
Secondary	Control Preference Scale (CPS)	The Control Preference Scale (CPS) measures physical therapists perception about their patient's preferences and patient's preference in SDM. The CPS is valid and reliable in healthcare decision making, easy to conduct and clinically relevant (Degner et al., 1997).	day 1 (e.g. "through study completion, an average of 1 year")

External Links

•   Dulmen, A.M., van, Bensing, J.M. (2001).The effect of context in healthcare: a programming study.