Skip to main content

Research Repository

Advanced Search

Communication practices that encourage and constrain shared decision making in health-care encounters: systematic review of conversation analytic research

Land, Victoria; Parry, Ruth H.; Jane, Seymour

Authors

Victoria Land victoria.land@hotmail.co.uk

Ruth H. Parry Ruth.Parry@nottingham.ac.uk

Seymour Jane



Abstract

Background: Shared decision making (SDM) is generally treated as good practice in health-care interactions. Conversation analytic research has yielded detailed findings about decision making in health-care encounters.
Objective: To map decision making communication practices relevant to health-care outcomes in face-to-face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM.
Search strategy: We searched nine electronic databases (last search November 2016) and our own and other academics’ collections.
Inclusion criteria: Published conversation analyses (no restriction on publication dates) using recordings of health-care encounters in English where the patient (and/or companion)was present and where the data and analysis focused on health/illness-related decision making.
Data extraction and synthesis: We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively.
Results: Twenty-eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organized these in relation to four elements of decision-making sequences: (i) broaching decision making; (ii) putting forward a course of action; (iii) committing or not (to the action put forward); and (iv) HCPs’ responses to patients’ resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs’ practices may constrain or encourage this participation.
Conclusions: Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non-negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (eg by bringing the patient towards shared understanding of the decision’s rationale).

Journal Article Type Article
Publication Date Dec 1, 2017
Journal Health Expectations
Print ISSN 1369-6513
Electronic ISSN 1369-7625
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 20
Issue 6
APA6 Citation Land, V., Parry, R. H., & Jane, S. (2017). Communication practices that encourage and constrain shared decision making in health-care encounters: systematic review of conversation analytic research. Health Expectations, 20(6), https://doi.org/10.1111/hex.12557
DOI https://doi.org/10.1111/hex.12557
Keywords conversation analysis, medical interaction, patient choice, patient participation, shared decision making, systematic review
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/hex.12557/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
Additional Information Systematic review is registered with PROSPERO: https://www.crd.york.ac...d.asp?ID=CRD42014009731

Files

Final proofs - Decision making systematic review (002).pdf (612 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





You might also like



Downloadable Citations

;