Patient perspectives of shared decision‐making in emergency surgery

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Main Authors: Rachel Spence, Susan Joan Moug, Meghan Minnis, Attika Chaudhary, Mairi Docherty, Sherzah Jamal, Shona MacTavish, Carly Nichola Bisset
Format: Artículo Open Access
Published: Wiley 2025
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author Rachel Spence
Susan Joan Moug
Meghan Minnis
Attika Chaudhary
Mairi Docherty
Sherzah Jamal
Shona MacTavish
Carly Nichola Bisset
author_facet Rachel Spence
Susan Joan Moug
Meghan Minnis
Attika Chaudhary
Mairi Docherty
Sherzah Jamal
Shona MacTavish
Carly Nichola Bisset
Rachel Spence
Susan Joan Moug
Meghan Minnis
Attika Chaudhary
Mairi Docherty
Sherzah Jamal
Shona MacTavish
Carly Nichola Bisset
collection Wiley Open Access
contents Patient perspectives of shared decision‐making in emergency surgery Rachel Spence Susan Joan Moug Meghan Minnis Attika Chaudhary Mairi Docherty Sherzah Jamal Shona MacTavish Carly Nichola Bisset Colorectal Disease AbstractAimShared decision‐making (SDM) is now considered the gold standard approach to counselling and obtaining patient consent. Research into patient perceptions of SDM is lacking and barriers to its implementation remain, specifically in the time‐pressurized, high‐risk emergency general surgery (EGS) setting. The aim of this work was to explore what EGS patients understand about SDM, gaining insight into their perspectives and experiences to understand the potential barriers both clinicians and patients may face.MethodThis work consisted of two parts: part 1 was an initial scoping review to inform the development of part 2—a patient and public involvement (PPI) exercise. The scoping review determined the quantity and quality of research in this area enabling long‐listing of known SDM concepts. This long‐list developed questions and structured discussions for the PPI exercise. Responses were transcribed, then analysed using thematic analysis.ResultsThe scoping review found limited evidence for both the implementation of SDM in EGS and patients' perspectives. Seven papers considered SDM in other settings that allowed long‐listing of the values and concepts for the PPI exercise. Nine patients and four supporters were identified from an established EGS database. After open discussion of the values and SDM concepts, thematic analysis was performed that identified two key themes: patient perceptions of how surgeons make decisions, and patient experiences of EGS decision‐making. Five subtheme analyses showed participants were not aware of surgeons' use of ‘30‐day mortality’ and could not quantify surgical risk, feeling time pressures and out of control. Almost all relied on surgeons to make their decision, valuing the surgeon's opinion over their own.ConclusionWith no previous reported evidence, this work provides the first patient insights into SDM in the EGS setting. With multiple barriers identified, further work is essential to increase implementation of this gold standard approach to patient consent. 10.1111/codi.70000 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/codi.70000
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institution Wiley Open Access
license_str_mv http://onlinelibrary.wiley.com/termsAndConditions#vor
publishDate 2025
publisher Wiley
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spellingShingle Patient perspectives of shared decision‐making in emergency surgery
Rachel Spence
Susan Joan Moug
Meghan Minnis
Attika Chaudhary
Mairi Docherty
Sherzah Jamal
Shona MacTavish
Carly Nichola Bisset
Colorectal Disease
Patient perspectives of shared decision‐making in emergency surgery Rachel Spence Susan Joan Moug Meghan Minnis Attika Chaudhary Mairi Docherty Sherzah Jamal Shona MacTavish Carly Nichola Bisset Colorectal Disease AbstractAimShared decision‐making (SDM) is now considered the gold standard approach to counselling and obtaining patient consent. Research into patient perceptions of SDM is lacking and barriers to its implementation remain, specifically in the time‐pressurized, high‐risk emergency general surgery (EGS) setting. The aim of this work was to explore what EGS patients understand about SDM, gaining insight into their perspectives and experiences to understand the potential barriers both clinicians and patients may face.MethodThis work consisted of two parts: part 1 was an initial scoping review to inform the development of part 2—a patient and public involvement (PPI) exercise. The scoping review determined the quantity and quality of research in this area enabling long‐listing of known SDM concepts. This long‐list developed questions and structured discussions for the PPI exercise. Responses were transcribed, then analysed using thematic analysis.ResultsThe scoping review found limited evidence for both the implementation of SDM in EGS and patients' perspectives. Seven papers considered SDM in other settings that allowed long‐listing of the values and concepts for the PPI exercise. Nine patients and four supporters were identified from an established EGS database. After open discussion of the values and SDM concepts, thematic analysis was performed that identified two key themes: patient perceptions of how surgeons make decisions, and patient experiences of EGS decision‐making. Five subtheme analyses showed participants were not aware of surgeons' use of ‘30‐day mortality’ and could not quantify surgical risk, feeling time pressures and out of control. Almost all relied on surgeons to make their decision, valuing the surgeon's opinion over their own.ConclusionWith no previous reported evidence, this work provides the first patient insights into SDM in the EGS setting. With multiple barriers identified, further work is essential to increase implementation of this gold standard approach to patient consent. 10.1111/codi.70000 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Patient perspectives of shared decision‐making in emergency surgery
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.70000