Bakhtawar Amin Medical and Dental College, Dental School, Department of Orthodontics (Multan, Pakistan).
Dental Press J Orthod. 2024 Sep 2;29(4):e242443. doi: 10.1590/2177-6709.29.4.e242443.oar. eCollection 2024.
Shared decision making (SDM) involves presenting patients with relevant information about a health issue and reaching a clinical decision based on their preferences. However, its application in orthodontics lacks documentation.
This study aimed to assess and compare the perspectives of patients and clinicians on SDM in different cases.
A cross-sectional study was conducted at a tertiary care hospital in Pakistan, involving 90 patients categorized into three groups (dentofacial orthopedics, orthognathic surgery, and conventional non-surgical fixed appliance treatment). Following clinical assessment and treatment plan discussions, patients and clinicians completed a 12-item dyadic observing patient involvement in decision making (OPTION) questionnaire, to gauge their perspectives on SDM. Mean OPTION scale scores were compared using paired sample t-tests between clinicians and patients, and intergroup comparisons utilized paired sample t-tests and Pearson correlation coefficients.
OPTION scores were similar between patients/parents and clinicians. However, statistically significant differences were found regarding the questions about "different sources of information", "different options (including the possibility of doing nothing)" and "concerns regarding management", with the patients giving overall lower OPTION scores. Patients gave lower SDM OPTION scores for conventional orthodontic treatment, but higher scores for orthopedic and orthognathic surgery, as compared to the clinicians.
The current study revealed an overall consensus in the mean total scores of OPTION scales between patients and clinicians. However, when stratified, patients showed higher SDM scores for orthopedic and orthognathic cases, and lower scores for conventional orthodontic treatment.
共同决策（SDM）涉及向患者提供有关健康问题的相关信息，并根据他们的偏好做出临床决策。然而，它在正畸学中的应用缺乏记录。
本研究旨在评估和比较患者和临床医生在不同情况下对 SDM 的看法。
在巴基斯坦的一家三级保健医院进行了一项横断面研究，涉及 90 名患者，分为三组（牙颌面矫形、正颌手术和常规非手术固定矫正治疗）。在进行临床评估和治疗计划讨论后，患者和临床医生完成了 12 项双观察患者参与决策（OPTION）问卷，以评估他们对 SDM 的看法。使用配对样本 t 检验比较临床医生和患者之间的 OPTION 量表得分，使用配对样本 t 检验和 Pearson 相关系数进行组间比较。
OPTION 得分在患者/家长和临床医生之间相似。然而，关于“不同的信息来源”、“不同的选择（包括不做任何处理的可能性）”和“对治疗的担忧”的问题存在统计学显著差异，患者的 OPTION 得分总体较低。与临床医生相比，患者对常规正畸治疗的 SDM OPTION 得分较低，但对矫形和正颌手术的得分较高。
本研究显示患者和临床医生在 OPTION 量表的总分上总体一致。然而，分层后，患者在矫形和正颌病例中表现出更高的 SDM 评分，而在常规正畸治疗中得分较低。
