Orthopedic surgery patients don't necessarily want to be involved in all aspects of clinical decision-making, according to a study published May 15 in the Journal of the American Academy of Orthopaedic Surgeons.
Researchers asked 115 patients at an orthopedic surgery clinic to rate their preferred level of involvement in 25 common clinical decisions. Involvement was categorized as passive, semipassive, equally shared between the patient and surgeon, semiactive or active.
Five key findings:
1. Patients preferred semipassive roles in 92 percent of the theoretical clinical decisions.
2. Patients wanted the most involvement in scheduling surgical treatment for a musculoskeletal condition. They wanted the least involvement in determining incision sizes.
3. Level of preferred decision-making involvement did not differ between patients who previously underwent orthopedic surgery and patients who had not.
4. Medicare patients generally preferred more passive involvement, while younger, educated patients preferred more decision-making responsibility.
5. When there are multiple ways to treat an orthopedic condition "without a clear superior option," shared decision-making is "thought to be the preferred method of decision-making," researchers said. As health policy increasingly emphasizes this kind of engagement, researchers concluded physicians should focus on shared decision-making in situations where patients actually want to be involved.
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