Abstract
Introduction Shared decision-making (SDM) is a process by which patients and clinicians work collaboratively to make decisions about healthcare. Previously, research has shown that patients want to be more involved in decisions about their care, but more recent evidence suggests that some patients may not wish to have the level of involvement that is now expected of them.
Aims This study therefore investigated adult orthodontic patients' preferred and perceived roles in treatment decision-making.
Methods This cross-sectional study was carried out in a teaching hospital using the Control Preferences Scale (CPS). This involved asking patients to choose one of five cards relating, firstly, to their preferred role in orthodontic decision-making, and then their perceived role in their current orthodontic treatment decision-making, and these were compared.
Results One hundred patients were recruited and perceived roles in decision-making tended to be more passive than those patients said they preferred. Males were significantly more likely to select a passive role than females (p = 0.018).
Conclusions Adult orthodontic patients perceived a more passive role in their current treatment decisions than they would have preferred. This highlights the importance of clinicians asking patients about their preferred role in treatment decision-making from the outset.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 24 print issues and online access
$259.00 per year
only $10.79 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
UK Government. Health and Social Care Act 2012. Available online at http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted (accessed April 2020).
Darzi A. Quality and the NHS next stage review. Lancet 2008; 371: 1563-1564.
Department of Health & Social Care. The NHS Constitution. 2015. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf (accessed April 2020).
Department of Health. Equity and excellence: Liberating the NHS. 2010. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/213823/dh_117794.pdf (accessed April 2020).
The Health Foundation. Person-centred care made simple: What everyone should know about person-centred care. 2016. Available at https://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple.pdf (accessed April 2020).
Coulter A, Collins A. Making shared decision-making a reality: No decision about me, without me. 2011. Available at https://www.kingsfund.org.uk/sites/default/files/Making-shared-decision-making-a-reality-paper-Angela-Coulter-Alf-Collins-July-2011_0.pdf (accessed April 2020).
Stiggelbout A M, Van der Weijden T, De Wit M P et al. Shared decision making: really putting patients at the centre of healthcare. BMJ 2012; DOI: 10.1136/bmj.e256.
Scholl I, Koelewijn-van Loon M, Sepucha K et al. Measurement of shared decision making - a review of instruments. Z Evid Fortbild Qual Gesundhwes 2011; 105: 313-324.
De Silva D. Helping people share decision making: a review of evidence considering whether shared decision making is worthwhile. 2012. Available at https://www.health.org.uk/sites/default/files/HelpingPeopleShareDecisionMaking.pdf (accessed April 2020).
Degner L F, Beaton J I. Life-death decisions in health care. Washington: Taylor & Francis, 1987.
Scheibler F, Janssen C, Pfaff H. Shared decision making: an overview of international research literature. Soz Praventivmed 2003; 48: 11-23.
Thompson A G. The meaning of patient involvement and participation in health care consultations: a taxonomy. Soc Sci Med 2007; 64: 1297-1310.
Chewning B, Bylund C L, Shah B, Arora N K, Gueguen J A, Makoul G. Patient preferences for shared decisions: a systematic review. Patient Educ Couns 2012; 86: 9-18.
Couët N, Desroches S, Robitaille H et al. Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument. Health Expect 2015; 18: 542-561.
Légaré F, Stacey D, Turcotte S et al. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev 2014; DOI: 10.1002/14651858.CD006732.pub2.
Fredriksson M, Eriksson M, Tritter J. Who wants to be involved in health care decisions? Comparing preferences for individual and collective involvement in England and Sweden. BMC Public Health 2018; 18: 18.
Degner L F, Sloan J A, Venkatesh P. The Control Preferences Scale. Can J Nurs Res 1997; 29: 21-43.
Chapple H, Shah S, Caress A L, Kay E J. Exploring dental patients' preferred roles in treatment decisionmakinga novel approach. Br Dent J 2003; 194: 321-327.
Reissmann D R, Bellows J C, Kasper J. Patient Preferred and Perceived Control in Dental Care Decision Making. JDR Clin Trans Res 2019; 4: 151-159.
Hanna K, Sambrook P, Armfield J M, Brennan D S. Preferences for dental decisional control and associations with quality of life among third molar patients attending public dental services. Community Dent Health 2017; 34: 163-168.
Tricou C, Yennu S, Ruer M, Bruera E, Filbet M. Decisional control preferences of patients with advanced cancer receiving palliative care. Palliat Support Care 2018; 16: 544-551.
Acknowledgements
We would like to thank all of the patients who were involved in this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
None to declare.
Rights and permissions
About this article
Cite this article
Motamedi-Azari, F., Ryan, F., Jones, E. et al. A cross-sectional study investigating patients' preferences regarding shared decision-making in adult orthodontic patients. Br Dent J 228, 869–874 (2020). https://doi.org/10.1038/s41415-020-1638-z
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41415-020-1638-z
This article is cited by
-
Impact of two different patient decision aids in prosthodontic consultations: a prospective randomized controlled study
Clinical Oral Investigations (2023)