Division of General Internal Medicine, Northwestern University, Chicago, IL, USA.
Patient Educ Couns. 2012 Sep;88(3):367-72. doi: 10.1016/j.pec.2012.06.011. Epub 2012 Jul 9.
To describe the development and refinement of a scheme, detail of essential elements and participants in shared decision making (DEEP-SDM), for coding shared decision making (SDM) while reporting on the characteristics of decisions in a sample of patients with metastatic breast cancer.
The evidence-based patient choice instrument was modified to reflect Makoul and Clayman's integrative model of SDM. Coding was conducted on video recordings of 20 women at the first visit with their medical oncologists after suspicion of disease progression. Noldus Observer XT v.8, a video coding software platform, was used for coding.
The sample contained 80 decisions (range: 1-11), divided into 150 decision making segments. Most decisions were physician-led, although patients and physicians initiated similar numbers of decision-making conversations.
DEEP-SDM facilitates content analysis of encounters between women with metastatic breast cancer and their medical oncologists. Despite the fractured nature of decision making, it is possible to identify decision points and to code each of the essential elements of shared decision making. Further work should include application of DEEP-SDM to non-cancer encounters.
A better understanding of how decisions unfold in the medical encounter can help inform the relationship of SDM to patient-reported outcomes.
描述一个方案的制定和完善过程，详细说明共享决策（SDM）的基本要素和参与者（DEEP-SDM），用于对转移性乳腺癌患者样本中的决策进行编码，并报告决策的特征。
对基于证据的患者选择工具进行了修改，以反映 Makoul 和 Clayman 的综合 SDM 模型。对 20 名女性在怀疑疾病进展后首次就诊时与他们的肿瘤内科医生进行的视频记录进行了编码。使用视频编码软件平台 Noldus Observer XT v.8 进行编码。
样本包含 80 个决策（范围：1-11），分为 150 个决策片段。大多数决策都是由医生主导的，尽管患者和医生发起的决策对话数量相似。
DEEP-SDM 有助于对转移性乳腺癌女性与肿瘤内科医生之间的相遇进行内容分析。尽管决策具有分散性，但仍有可能确定决策点，并对共享决策的每个基本要素进行编码。进一步的工作应包括将 DEEP-SDM 应用于非癌症的相遇。
更好地了解决策在医疗接触中是如何展开的，可以帮助了解 SDM 与患者报告的结果之间的关系。
