Hausheer A1, Suter L2, Kool J3
1Zurich University of Applied Sciences / Institute of Physiotherapy, School of Health Professions, Winterthur, Switzerland, 2Zurich University of Applied Sciences, School of Health Professions, Winterthur, Switzerland, 3Rehabilitation Centre Kliniken Valens, Research Department, Valens, Switzerland
Background: Shared decision-making (SDM) reduces the unbalanced power between physical therapists and patients and improves patients' satisfaction and health outcomes.
Purpose: The objectives of this study were to detect physical therapists' SDM behaviour in different settings, to determine agreement between patients' preferred levels of involvement in SDM and therapists' perceptions of patients' preferences, and to examine predictors of SDM behaviour.
Methods: Thirty physical therapy consultations were audio recorded and analysed in respect to SDM behaviour by using the OPTION instrument. A pre-defined threshold of 35 and more was defined as good standard. The control preference scale (CPS) measured patients' preferred levels of involvement in the SDM process and therapists' perceptions of patients' preferences. SDM behaviour was analysed using descriptive statistics. The Mann-Whitney U test was used to analyse potential differences among therapy settings and physical therapists' education levels. Predictors of SDM behaviour were analysed by a multivariate regression.
Results: The OPTION instrument showed a median of 50.50 (44.00, 66.00) out of 100. A significant group difference was found between therapy settings (Z= -3.666, P= 0.000) and between education levels (Z= -2.018, P=0.044) regarding SDM behaviour. Agreement between patients and physical therapists regarding involvement level was poor at weighted kappa of -0.261 (95% CI -0.514 to -0.007). In 50% of the observations, patients wanted to be more involved than physical therapists perceived. Therapy settings, education levels and the interaction of education and work experience predicted SDM behaviour (b=15.760, P=0.000; b=8.045, P=0.048; b=-0.328, P=0.016).
Conclusion(s): SDM behaviour was of good standard. Education was the main predictor for good SDM behaviour. Further research is required regarding the relationship between education and communication skills in a longitudinal study design.
Implications: Physical therapists should be better equipped in communication strategies to improve their SDM behaviour.
Keywords: Shared decision-making, education level, agreement
Funding acknowledgements:
This study was unfounded.
MSc Hausheer, PhD Kool, MSc Suter developed the concept and research design.
Purpose: The objectives of this study were to detect physical therapists' SDM behaviour in different settings, to determine agreement between patients' preferred levels of involvement in SDM and therapists' perceptions of patients' preferences, and to examine predictors of SDM behaviour.
Methods: Thirty physical therapy consultations were audio recorded and analysed in respect to SDM behaviour by using the OPTION instrument. A pre-defined threshold of 35 and more was defined as good standard. The control preference scale (CPS) measured patients' preferred levels of involvement in the SDM process and therapists' perceptions of patients' preferences. SDM behaviour was analysed using descriptive statistics. The Mann-Whitney U test was used to analyse potential differences among therapy settings and physical therapists' education levels. Predictors of SDM behaviour were analysed by a multivariate regression.
Results: The OPTION instrument showed a median of 50.50 (44.00, 66.00) out of 100. A significant group difference was found between therapy settings (Z= -3.666, P= 0.000) and between education levels (Z= -2.018, P=0.044) regarding SDM behaviour. Agreement between patients and physical therapists regarding involvement level was poor at weighted kappa of -0.261 (95% CI -0.514 to -0.007). In 50% of the observations, patients wanted to be more involved than physical therapists perceived. Therapy settings, education levels and the interaction of education and work experience predicted SDM behaviour (b=15.760, P=0.000; b=8.045, P=0.048; b=-0.328, P=0.016).
Conclusion(s): SDM behaviour was of good standard. Education was the main predictor for good SDM behaviour. Further research is required regarding the relationship between education and communication skills in a longitudinal study design.
Implications: Physical therapists should be better equipped in communication strategies to improve their SDM behaviour.
Keywords: Shared decision-making, education level, agreement
Funding acknowledgements:
This study was unfounded.
MSc Hausheer, PhD Kool, MSc Suter developed the concept and research design.
Topic: Education; Musculoskeletal
Ethics approval required: Yes
Institution: Rehabilitation Centre Kliniken Valens; Zurich University of Applied Sciences
Ethics committee: EKSG
Ethics number: 2017-00848
All authors, affiliations and abstracts have been published as submitted.
