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Shared decision making in the management of midshaft clavicular fractures: Nonoperative treatment or plate fixation.
- Source :
-
Injury . Apr2017, Vol. 48 Issue 4, p920-924. 5p. - Publication Year :
- 2017
-
Abstract
- <bold>Introduction: </bold>Most patients with a displaced midshaft clavicular fracture can be treated either operatively or nonoperatively, with similar long-term outcomes. The treatment choice depends on individual preferences, and is therefore suited for a shared decision making (SDM) approach. However, little is known about SDM in fracture treatment. The purpose of this study was to evaluate the current daily practice of shared decisional behaviour in clavicular fracture treatment, in order to assess the need for improvement and set a baseline level for future research.<bold>Patients and Methods: </bold>All consecutive adult patients treated in two hospitals for a displaced, midshaft clavicular fracture in 2015 filled out a questionnaire shortly after the decision making moment, that consisted of questions concerning their knowledge and preferences regarding the treatment options; the SDM-Q-9-NL to measure the perceived degree of SDM, and the Control Preferences Scale to measure patients' preferred and actual roles in decision making.<bold>Results: </bold>Fifty patients were included. Eighteen percent of the patients were unaware of the treatment options before the consultation, 48% had no preference for either treatment option. The mean score for perceived degree of SDM was 74 out of 100 (SD 23, range 12.5-100). In 68% of patients, the preferred role matched the actual role in making the decision. Sixteen patients (32%) would have preferred either a less (n=8) or a more (n=8) active role.<bold>Conclusion: </bold>The patient-reported level of SDM in treatment decisions for clavicular fractures was high, but not all patients had the role in this process that they preferred. To improve patients' involvement in the treatment decision making process for clavicular fractures, it is important to create general awareness about SDM, and increase knowledge of orthopaedic trauma surgeons about SDM behaviour. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CLAVICLE injury treatment
*MEDICAL decision making
*FRACTURE fixation
*ORTHOPEDIC surgery
*HEALTH outcome assessment
*CLAVICLE injuries
*BONE fractures
*COMPARATIVE studies
*DECISION making
*HEALTH attitudes
*RESEARCH methodology
*MEDICAL cooperation
*MEDICAL referrals
*ORTHOPEDIC implants
*PHYSICIAN-patient relations
*QUESTIONNAIRES
*RESEARCH
*RISK assessment
*PATIENT participation
*EVALUATION research
*RANDOMIZED controlled trials
*TREATMENT effectiveness
*CROSS-sectional method
*FRACTURE healing
*PSYCHOLOGY
*THERAPEUTICS
PSYCHOLOGICAL aspects
Subjects
Details
- Language :
- English
- ISSN :
- 00201383
- Volume :
- 48
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 122310995
- Full Text :
- https://doi.org/10.1016/j.injury.2017.02.032