Assessing Shared Decision‐Making Clinical Behaviors Among Genetic Counsellors

Shared decision‐making (SDM) is a collaborative approach in which clinicians educate, support, and guide patients as they make informed, value‐congruent decisions. SDM improves patients' health‐related outcomes through increasing knowledge, reducing decisional conflict, and enhancing experience...

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Bibliographic Details
Published in:Journal of genetic counseling 2019-02, Vol.28 (1), p.40-49
Main Authors: Birch, Patricia H., Adam, S., Coe, R. R., Port, A. V., Vortel, M., Friedman, J. M., Légaré, F.
Format: Article
Language:English
Subjects:
Anxiety
Behavior
Clinical decision making
Clinical outcomes
Collaborative approach
Counselors
Decision making
Decisional conflict
Evidence-based practice
Genetic counseling
Genetic counselling
Group decision making
Health status
Infants
OPTION12
Patient participation
Pregnancy
Prenatal care
Shared decision‐making
Training
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Summary:Shared decision‐making (SDM) is a collaborative approach in which clinicians educate, support, and guide patients as they make informed, value‐congruent decisions. SDM improves patients' health‐related outcomes through increasing knowledge, reducing decisional conflict, and enhancing experience of care. We measured SDM in genetic counselling appointments with 27 pregnant women who were at increased risk to have a baby with a genetic abnormality. The eight experienced genetic counsellors who participated had no specific SDM training and were unaware that SDM was being assessed. Audio transcripts of appointments were scored using ‘Observing Patient Involvement in Decision Making' (OPTION12). Patients' anxiety and decisional conflict were also assessed. The genetic counsellors' mean OPTION12score was 42.4% (SD 9.0%; possible range 0–100%). Specific SDM behaviours that scored highest included introducing the concept of equipoise and listing all options with their pros and cons. Behaviours that scored lowest included eliciting patients' preferred approach to receiving information and desired degree of involvement in decision‐making. Patients' levels of anxiety and decisional conflict were unassociated with genetic counsellors' OPTION12scores. Some SDM behaviours were better demonstrated in this prenatal genetic counselling study than others. Formal training of genetic counsellors in SDM may enhance use of this approach in their professional practice.
ISSN:1059-7700
1573-3599
DOI:10.1007/s10897-018-0285-x