Theme 2 SDM

Question 1

Paternalism

Answer 1

doctor decides everyting

Question 2

Consumerism

Answer 2

informed choice, patients has final say

Question 3

Choice talk

Answer 3

exchange of medical and personal information between patient and doctor

Question 4

Option talk

Answer 4

Possible options and outcomes are discussed

Question 5

Decision talk

Answer 5

Doctor and patient reach consensus about what needs to be done

Question 6

Why SDM?

Answer 6

Increases autonomy
Increases cost-effectiveness
Improves treatment relationships which leads to enhanced patient adherence, more satisfaction, better clinical outcomes

Question 7

Improved relationships lead to

Answer 7

Enhanced patient adherence
Better clinical outcomes
More satisfaction

Question 8

Obstacles of SDM

Answer 8

Dominant doctors
Docile patients
Lack of time
Stress
Lack of skills
Communication problems

Question 9

SDM appropriate for

Answer 9

Relatively healthy patients
Patients w/ active coping abilities
Patients w/ chronic conditions
Uncertain effective means of outcome

Question 10

SDM less appropriate for

Answer 10

Elderly
Less educated patients
Acute or very severe somatic problems
Taking minor decisions
Patients w/ mental health problems

Question 11

Approach to SDM

Answer 11

Help patients understand the risk and benefits of their alternatives
Help patients align their goals with those risks and benefits
Assist patients in making choices that promote their goals and reflects their autonomous right to decide

Question 12

Objections to SDM

Answer 12

Harming patients having difficultiy w/ decision making
Growing awereness of missed opportunities
Patients dont appreciate outcomes
Raises expectations > dissapointment, dissatisfaction

Question 13

Requirements for SDM

Answer 13

Legislation (not favouring consumerism)
Investment in development of decision aids
Attention in trainingprograms of doctors
Spread of the positive influence SDM has
Will of clinicians to participate SDM