Jun Xu1, Anya E R Prince2. 1. Division of Vascular Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address: jun-xu-1@uiowa.edu. 2. University of Iowa College of Law, Iowa City, Iowa.
Abstract
BACKGROUND: Ideally, patients' decision-making regarding surgical options should reflect myriad implicit values. The informed consent process is meant to ensure that patients' values mirror clinical decisions regarding expectations for outcomes, such as quality of life, life expectancy, and subsequent pain and suffering. However, surgeons are not always equipped to discuss patients' values. METHODS: Shared decision-making is a method that could help surgeons elicit patients' values and subsequently improve the patient's knowledge and satisfaction, among other important outcomes. Yet, several barriers hinder implementation of shared decision-making in the clinic, such as time, interpersonal characteristics, and trust. To address concerns, several tools and approaches have been developed to increase shared decision-making in the clinic. This article highlights two strategies: the three-talk model and decision aids. CONCLUSIONS: Shared decision-making is a tool that could be especially valuable in discussions regarding elective surgery. Further research is needed to determine how best to implement shared decision-making in the surgical setting. Without full integration of patients' values into discussions of surgical options, there will continue to be a disconnect between the surgical procedures, outcomes, and patients' values.
BACKGROUND: Ideally, patients' decision-making regarding surgical options should reflect myriad implicit values. The informed consent process is meant to ensure that patients' values mirror clinical decisions regarding expectations for outcomes, such as quality of life, life expectancy, and subsequent pain and suffering. However, surgeons are not always equipped to discuss patients' values. METHODS: Shared decision-making is a method that could help surgeons elicit patients' values and subsequently improve the patient's knowledge and satisfaction, among other important outcomes. Yet, several barriers hinder implementation of shared decision-making in the clinic, such as time, interpersonal characteristics, and trust. To address concerns, several tools and approaches have been developed to increase shared decision-making in the clinic. This article highlights two strategies: the three-talk model and decision aids. CONCLUSIONS: Shared decision-making is a tool that could be especially valuable in discussions regarding elective surgery. Further research is needed to determine how best to implement shared decision-making in the surgical setting. Without full integration of patients' values into discussions of surgical options, there will continue to be a disconnect between the surgical procedures, outcomes, and patients' values.
Authors: Kosmas I Paraskevas; Dimitri P Mikhailidis; Hediyeh Baradaran; Alun H Davies; Hans-Henning Eckstein; Gianluca Faggioli; Jose Fernandes E Fernandes; Ajay Gupta; Mateja K Jezovnik; Stavros K Kakkos; Niki Katsiki; M Eline Kooi; Gaetano Lanza; Christos D Liapis; Ian M Loftus; Antoine Millon; Andrew N Nicolaides; Pavel Poredos; Rodolfo Pini; Jean-Baptiste Ricco; Tatjana Rundek; Luca Saba; Francesco Spinelli; Francesco Stilo; Sherif Sultan; Clark J Zeebregts; Seemant Chaturvedi Journal: J Stroke Date: 2021-05-31 Impact factor: 6.967