Patients’ perspective on shared decision-making in urology: a prospective study at a university hospital

• Published in: World journal of urology Vol. 39; no. 12; pp. 4491 - 4498
• Main Authors: Grüne, Britta, Köther, Anja K., Büdenbender, Björn, Michel, Maurice S., Kriegmair, Maximilian C., Alpers, Georg W.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2021; Springer Nature B.V
• Subjects: Attitude to Health; Clinical decision making; Decision making; Decision Making, Shared; Emotions; Female; Hospitals, University; Humans; Immigration; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original Article; Patient Participation; Patient Preference; Patients; Prospective Studies; Statistical analysis; Urologic Diseases - psychology; Urologic Diseases - therapy; Urology; Involvement; Questionnaire; Patient-centered care; Shared decision-making
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-021-03794-3

Purpose This study aims to determine the degree of shared decision-making (SDM) from urological patients’ perspective and to identify possible predictors. Methods Overall, 469 urological patients of a university outpatient clinic were recruited for this prospective study. Before a medical consultation, clinical and sociodemographic information, and patients’ emotional distress were assessed by questionnaires. After the consultation, patients completed the SDM-Questionnaire-9 (SDM-Q-9). The SDM-Q-9 scores of relevant subgroups were compared. Logistic regression was used to identify patients at risk for experiencing low involvement (SDM-Q-9 total score ≤ 66) in SDM. Results Data from 372 patients were available for statistical analyses. The SDM-Q-9 mean total score was 77.8 ± 20.6. The majority of patients ( n  = 271, 73%) experienced a high degree of involvement (SDM-Q-9 total score > 66). The mean score per SDM-Q-9 item was in the upper range (3.9 ± 1.4 out of 5). The most poorly rated item was “My doctor wanted to know how I want to be involved in decision-making” (3.5 ± 1.6). Immigration status (OR 3.7, p  = 0.049), and nonscheduled hospital registration (OR 2.1, p  = 0.047) were significant predictors for less perceived involvement. Comorbidity, oncological status, and emotional distress did not significantly predict perceived participation. Conclusion In a university hospital setting, most urological patients feel adequately involved in SDM. Nevertheless, urologists should routinely ask for patients’ participation preference. Patients without a scheduled appointment and patients who immigrated may need more support to feel involved in SDM.