2017 | 43 | 2 | 143-160
Article title

What connects us in shared decision-making in health

Title variants
Co nas łączy w podejmowaniu wspólnych decyzji o zdrowiu
Languages of publication
This paper discusses the mechanisms that lead to consensus in shared decision-making (SDM) from a theoretical point of view. It considers the way in which SDM interventions are expected to share information, preferences and create shared mental representations in treatment decisions. It draws on consensus theory to argue that both content-based and process-based consensus are needed in SDM interventions in order to achieve an acceptable level of shared-ness. Three types of conditions are identified from the literature for fostering consensus: content, agent and process conditions. These conditions are further pursued in one Practitioner Training support document and one SDM intervention evaluation report. The analysis revealed that the SDM interventions analyzed pursue only process-based consensus, while disregarding content-based consensus. Further research is required for generalized conclusions. Further implications for practice of these findings are expected to be in the area of patient adherence to treatment and patient satisfaction with service quality.
Niniejszy tekst dotyczy mechanizmów umożliwiających osiąganie konsensusu w podejmowaniu wspólnych decyzji z teoretycznego punktu widzenia. Odnosi się do sposobu, w jakim wspólna wiedza i oczekiwania wpływają na podejmowanie wspólnych decyzji oraz tworzą reprezentacje mentalne w kontekście decyzji dotyczących leczenia. Opiera się na teorii konsensusu, co pozwala uzasadnić konieczność występowania w interwencjach dotyczących podejmowania wspólnych decyzji zarówno konsensusu opartego na treści, jak i rozumianego jako proces dla osiągnięcia akceptowalnego poziomu współodpowiedzialności. W literaturze można odnaleźć trzy rodzaje warunków wspierających osiąganie konsensusu: wewnętrzne, indywidualne i zewnętrzne czynniki procesu. Trzy wymienione warunki zostały zastosowane w dokumencie wspierającym szkolenie pracowników służby zdrowia i raporcie z ewaluacji interwencji w podejmowanie wspólnej decyzji. Analizy pokazały, że przedstawiona interwencja w podejmowanie wspólnych decyzji doprowadziła jedynie do konsensusu opartego na procesie, pomijając konsensus oparty o treść. Formułowanie ogólnych wniosków wymaga prowadzenia dalszych badań. Dalszych implikacji omówionych wyników dla praktyki można się spodziewać w obszarze przywiązania pacjenta do sposobu leczenia i jego satysfakcji z jakości usług.
Physical description
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