Maher Natasha, Moffatt Maria Clare, Astin Felicity, Littlewood Chris
Calderdale Royal Hospital, Calderdale and Huddersfield NHS Foundation Trust, Halifax, UK.
School of Allied Health Professions and Nursing, University of Liverpool, Institute of Population Health, Liverpool, UK.
Clin Rehabil. 2025 Aug;39(8):1105-1115. doi: 10.1177/02692155251355440. Epub 2025 Jun 30.
ObjectiveTo explore the patient experience of shared decision-making following a displaced collarbone injury, focusing on how patients understand their injury and how this influences decisions.DesignDescriptive qualitative study design using individual semi-structured interviews.SettingParticipants recruited from three United Kingdom National Health Service hospitals.ParticipantsPatients with a displaced collarbone injury were interviewed about their experiences of shared decision-making.Main measuresInterviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis.ResultsThree themes emerged: (1) Understanding of the injury, (2) Factors influencing treatment decision and (3) Experience of shared decision-making. Patients' interpretation of their injury, including the language used by clinicians, shaped their understanding and decisions. Factors such as previous injuries, employment, clinician advice and expectations also influenced treatment choices. Some patients described uncertainty during decision-making conversations and felt unsupported in choosing the option that best suited them. Others felt steered towards specific treatments without fully grasping their implications.ConclusionThis is the first qualitative interview study exploring patients' perspectives of shared decision-making following a displaced collarbone injury. While patients considered several factors when deciding between treatment options, many described limited involvement in decision-making and felt directed towards clinician-preferred treatments without fully understanding the implications. This highlights inconsistency in the implementation of shared decision-making in practice. Despite the United Kingdom National Health Service emphasis on shared decision-making, further efforts are needed to ensure that patients are actively supported in making informed, preference-sensitive decisions, in line with the goals of personalised care.
目的
探讨锁骨移位骨折患者参与共同决策的体验，重点关注患者如何理解自身损伤以及这如何影响决策。
设计
采用个人半结构式访谈的描述性定性研究设计。
设置
从英国三家国民健康服务医院招募参与者。
参与者
对锁骨移位骨折患者进行访谈，了解他们参与共同决策的经历。
主要测量方法
访谈进行录音，逐字转录，并采用归纳主题分析法进行分析。
结果
（1）对损伤的理解，（2）影响治疗决策的因素，（3）共同决策的体验。患者对自身损伤的解读，包括临床医生使用的语言，塑造了他们的理解和决策。既往损伤、工作、临床医生的建议和期望等因素也影响治疗选择。一些患者描述了决策过程中的不确定性，并且在选择最适合自己的方案时感到缺乏支持。另一些患者感觉在没有完全理解其影响的情况下被引导至特定治疗方案。
结论
这是第一项探索锁骨移位骨折患者对共同决策看法的定性访谈研究。虽然患者在选择治疗方案时考虑了多个因素，但许多患者表示在决策过程中的参与有限，感觉被引导至临床医生偏好的治疗方案，而没有完全理解其影响。这凸显了共同决策在实践中实施的不一致性。尽管英国国民健康服务强调共同决策，但仍需进一步努力，以确保患者在做出明智的、符合个人偏好的决策时得到积极支持，这符合个性化医疗的目标。
