Understanding patient perceptions of shared decision making

Patient Educ Couns. 2014 Sep;96(3):295-301. doi: 10.1016/j.pec.2014.07.017. Epub 2014 Jul 21.


Objective: This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared.

Methods: Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis.

Results: Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision.

Conclusion: There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of "agreement" may be more important than the actual decision-making process for patients to label a decision as shared.

Practice implications: Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM.

Keywords: Patient perceptions; Primary care decision-making; Qualitative interviews; Shared decision making.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Attitude of Health Personnel
  • Communication*
  • Decision Making*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Models, Psychological*
  • Patient Participation*
  • Perception
  • Physician's Role
  • Physician-Patient Relations
  • Primary Health Care
  • Qualitative Research
  • Trust