Collaborative deliberation: A model for patient care

Elwyn, Glyn, Lloyd, Amy, May, Carl, van der Weijden, Trudy, Stiggelbout, Anne, Edwards, Adrian, Frosch, Dominick, Rapley, Timothy, Barr, Paul, Walsh, Thom, Grande, Stuart, Montori, Victor and Epstein, Ronald (2014) Collaborative deliberation: A model for patient care. Patient Education and Counseling, 97 (2). pp. 158-164. ISSN 0738-3991

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Official URL: http://dx.doi.org/10.1016/j.pec.2014.07.027

Abstract

Objective
Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others.

Methods
Theory building among researchers with experience and expertise in clinician–patient communication, using an iterative cycle of discussions.

Results
We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model ‘collaborative deliberation.’ The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration.

Conclusions
We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making.

Item Type: Article
Uncontrolled Keywords: Patient centered care, Shared decision making, Motivational interviewing, Behavior change, Patient–clinician communication
Subjects: B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Social Work, Education and Community Wellbeing
Depositing User: Becky Skoyles
Date Deposited: 03 Jul 2018 12:27
Last Modified: 03 Jul 2018 12:27
URI: http://nrl.northumbria.ac.uk/id/eprint/34798

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