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Brazilian Journal of Physical Therapy 2022Shared decision making is a means of translating evidence into practice and facilitating patient-centred care by helping patients to become more active in the... (Review)
Review
BACKGROUND
Shared decision making is a means of translating evidence into practice and facilitating patient-centred care by helping patients to become more active in the decision-making process. Shared decision making is a collaborative process that involves patients and clinicians making health-related decisions after discussing the available options; the benefits and harms of each option; and considering the patient's values, preferences, and personal circumstances.
METHODS
This paper describes what shared decision making is, why it is important, when it is appropriate, and key elements. We report on physical therapists' current use of and attitudes to shared decision making and explore factors that influence its uptake. Lastly, we examine what is needed to promote greater use of this approach.
RESULTS
Key elements in the shared decision making process are: identifying the problem that requires a decision; providing an explanation of the health problem, including, where appropriate, the natural history of the condition; discussing the available options and the potential benefits and harms of each option; eliciting the patient's values, preferences, and expectations; and assisting the patient to weigh up the options to reach an informed decision. When applied in practice, shared decision making has been found to improve patient-clinician communication; improve patients' accuracy of their expectations of intervention benefits and harms, involvement in decision-making, and feeling of being informed; and increase both patients' and clinicians' satisfaction with care.
CONCLUSION
Despite physical therapists' enthusiasm for shared decision making, uptake of this approach has been slow. Multi-level strategies and behaviour change are required to encourage and support the sustainable incorporation of shared decision making in practice.
Topics: Decision Making; Decision Making, Shared; Humans; Patient Participation; Patient-Centered Care; Physical Therapy Modalities
PubMed: 35063699
DOI: 10.1016/j.bjpt.2021.100382 -
Patient Education and Counseling Jul 2021Cooperation has emerged as a fundamental characteristic of human society, and many argue that this ability is the basis for the phenomenal development in our capability...
Cooperation has emerged as a fundamental characteristic of human society, and many argue that this ability is the basis for the phenomenal development in our capability as a species. When we focus our attention to the interactions that occur in healthcare, we inevitably notice power asymmetry due to unequal knowledge, experience, and status. However, as many have argued since the 1970s, there is an ethical imperative to respect the agency of individuals, offer information, collaborate, and support deliberation when difficult decisions arise. This process is particularly important when reasonable alternative courses of action exist and where the priorities and preferences of individuals would be expected to sway such decisions. This position article argues that this process, commonly described as shared decision making, involves work that is cognitive, emotional, and relational, and, particularly if people are ill, should have the underpinning goal of restoring autonomy. It covers the origin of the term and describes the core components; it describes how to do the cognitive, emotional, and relational work that is required, and offers a model to guide the process.
Topics: Communication; Decision Making; Decision Making, Shared; Emotions; Humans
PubMed: 33353840
DOI: 10.1016/j.pec.2020.11.032 -
Annual Review of Psychology Jan 2020The science of judgment and decision making involves three interrelated forms of research: analysis of the decisions people face, description of their natural responses,... (Review)
Review
The science of judgment and decision making involves three interrelated forms of research: analysis of the decisions people face, description of their natural responses, and interventions meant to help them do better. After briefly introducing the field's intellectual foundations, we review recent basic research into the three core elements of decision making: judgment, or how people predict the outcomes that will follow possible choices; preference, or how people weigh those outcomes; and choice, or how people combine judgments and preferences to reach a decision. We then review research into two potential sources of behavioral heterogeneity: individual differences in decision-making competence and developmental changes across the life span. Next, we illustrate applications intended to improve individual and organizational decision making in health, public policy, intelligence analysis, and risk management. We emphasize the potential value of coupling analytical and behavioral research and having basic and applied research inform one another.
Topics: Decision Making; Human Development; Humans; Individuality; Judgment
PubMed: 31337275
DOI: 10.1146/annurev-psych-010419-050747 -
Neuroscience and Biobehavioral Reviews May 2020The scientific study of animal affect (emotion) is an area of growing interest. Whilst research on mechanism and causation has predominated, the study of function is... (Review)
Review
The scientific study of animal affect (emotion) is an area of growing interest. Whilst research on mechanism and causation has predominated, the study of function is less advanced. This is not due to a lack of hypotheses; in both humans and animals, affective states are frequently proposed to play a pivotal role in coordinating adaptive responses and decisions. However, exactly how they might do this (what processes might implement this function) is often left rather vague. Here we propose a framework for integrating animal affect and decision-making that is couched in modern decision theory and employs an operational definition that aligns with dimensional concepts of core affect and renders animal affect empirically tractable. We develop a model of how core affect, including short-term (emotion-like) and longer-term (mood-like) states, influence decision-making via processes that we label affective options, affective predictions, and affective outcomes and which correspond to similar concepts in schema of the links between human emotion and decision-making. Our framework is generalisable across species and generates questions for future research.
Topics: Affect; Animals; Behavior, Animal; Decision Making; Models, Biological
PubMed: 31991192
DOI: 10.1016/j.neubiorev.2020.01.025 -
Allergy and Asthma Proceedings Jul 2022Clinical decision-making in allergic rhinoconjunctivitis management involves a significant degree of complexity given the number of pharmaceutical agents; the option for... (Review)
Review
Clinical decision-making in allergic rhinoconjunctivitis management involves a significant degree of complexity given the number of pharmaceutical agents; the option for allergen immunotherapy (AIT); and the risk for disease advancement, including the development of asthma as well as new environmental allergic sensitivities. Given the complex array of treatment options that are currently available, there is an opportunity to use a shared decision-making (SDM) approach with associated aids and tools that facilitate the interactive participation of practitioners and patients in the SDM process. This article reviews the general constructs of SDM, the unmet need for SDM aids, the collection of patient preference data for allergic rhinoconjunctivitis, the utility of SDM aids which have been specifically created for AIT, and outlines actionable steps to implement AIT SDM in clinical practice.
Topics: Humans; Decision Making; Decision Making, Shared; Desensitization, Immunologic; Patient Participation
PubMed: 35818138
DOI: 10.2500/aap.2022.43.220017 -
Annual Review of Psychology Jan 2021To explain trade-offs in choice, researchers have proposed myriad phenomena and decision rules, each paired with separate theories and idiosyncratic vocabularies. Yet... (Review)
Review
To explain trade-offs in choice, researchers have proposed myriad phenomena and decision rules, each paired with separate theories and idiosyncratic vocabularies. Yet most choice problems are ultimately resolved with one of just two types of solutions: mixed or extreme. For example, people adopt mixed solutions for resolving trade-offs when they allow exercising to license indulgence afterward (balancing between goals), read different literary genres (variety seeking), and order medium-sized coffees (the compromise effect). By contrast, when people adopt extreme solutions for resolving these exact same trade-offs, they exhibit highlighting, consistency seeking, and compromise avoidance, respectively. Our review of the choice literature first illustrates how many seemingly unrelated phenomena actually share the same underlying psychology. We then identify variables that promote one solution versus the other. These variables, in turn, systematically influence which of opposite choice effects arise (e.g., highlighting versus balancing). Finally, we demonstrate how several mistakes people purport to make can potentially instead be reinterpreted as mixed solutions for resolving trade-offs. We conclude with guidance for distinguishing mistakes from mixed solutions.
Topics: Choice Behavior; Decision Making; Goals; Humans; Judgment
PubMed: 32898463
DOI: 10.1146/annurev-psych-072420-125709 -
Topics in Cognitive Science Jan 2022Humans make decisions in dynamic environments (increasingly complex, highly uncertain, and changing situations) by searching for potential alternatives sequentially over...
Humans make decisions in dynamic environments (increasingly complex, highly uncertain, and changing situations) by searching for potential alternatives sequentially over time, to determine the best option at a precise moment. Surprisingly, the field of behavioral decision making has little to offer in terms of theoretical principles and practical guidelines on how people make decisions in dynamic situations. My research program aims to fill in this gap by developing theoretical understandings of decision processes as well as practical demonstrations of how these theoretical developments can improve human dynamic decision making. Throughout my research career, I have helped create, test, and improve a general theory of dynamic decision making, instance-based learning theory, IBLT. The methods I have used to contribute to IBLT are (1) laboratory experiments that rely on dynamic games in which humans make choices over time and space, individually and in teams, and from which we extrapolate robust phenomena and behavioral insights; and (2) computational, actionable cognitive models, which specify the decision-making process and the cognitive mechanisms involved into a computational algorithm. The combination of these methods spawned novel applications in areas such as cybersecurity, phishing, climate change, and human-machine interactions. In this paper, I will take you through my own intellectual exploratory experience of computational modeling of human decision processes, and how the integration of experimental work and cognitive modeling helped in discovering and uncovering the field of dynamic decision making.
Topics: Decision Making; Humans; Learning; Uncertainty
PubMed: 34767300
DOI: 10.1111/tops.12581 -
Therapeutische Umschau. Revue... 2022
Topics: Decision Making; Decision Making, Shared; Humans; Patient Participation
PubMed: 36164736
DOI: 10.1024/0040-5930/a001374 -
Cognitive, Affective & Behavioral... Jun 2023There is a great deal of uncertainty in the world. One common source of uncertainty results from incomplete or missing information about probabilistic outcomes (i.e.,... (Review)
Review
There is a great deal of uncertainty in the world. One common source of uncertainty results from incomplete or missing information about probabilistic outcomes (i.e., outcomes that may occur), which influences how people make decisions. The impact of this type of uncertainty may particularly pronounced for older adults, who, as the primary leaders around the world, make highly impactful decisions with lasting outcomes. This review examines the ways in which uncertainty about probabilistic outcomes is perceived, handled, and represented in the aging brain, with an emphasis on how uncertainty may specifically affect decision making in later life. We describe the role of uncertainty in decision making and aging from four perspectives, including 1) theoretical, 2) self-report, 3) behavioral, and 4) neuroscientific. We report evidence of any age-related differences in uncertainty among these contexts and describe how these changes may affect decision making. We then integrate the findings across the distinct perspectives, followed by a discussion of important future directions for research on aging and uncertainty, including prospection, domain-specificity in risk-taking behaviors, and choice overload.
Topics: Humans; Aged; Uncertainty; Aging; Brain; Decision Making
PubMed: 36670294
DOI: 10.3758/s13415-023-01064-w -
Patient Education and Counseling Jun 2024
Topics: Humans; Decision Making, Shared; Decision Making; Physician-Patient Relations; Patient Participation
PubMed: 38508885
DOI: 10.1016/j.pec.2024.108249