Cultural challenges to engaging patients in shared decision making

PATIENT EDUCATION AND COUNSELING

卷:100

Article

Hawley, Sarah T.¹  Morris, Arden M.² 

[1] Univ Michigan & Res Investigator, Ann Arbor VA Ctr Clin Management Res, Med & Hlth Management & Policy, 2800 Plymouth Rd,4th Floor, Ann Arbor, MI 48109 USA

[2] Univ Michigan, Surg & Hlth Behav & Hlth Educ, Ann Arbor, MI 48109 USA

关键词: Shared decision-making;    Cultural challenges;    Health care provider-patient communication;    Patient engagement;   

DOI  :  10.1016/j.pec.2016.07.008

来源: Elsevier

【 摘 要 】

Objective: Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. Discussion: The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. Conclusion: While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. Published by Elsevier Ireland Ltd.

【 授权许可】

Free