Shared decision making for people living with multimorbidity: A concept analysis

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-02-22 DOI:10.1016/j.pec.2025.108712

Shupeng Shi , Xingzhou Liu , Yongjie Li , Chuan Yang

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引用次数: 0

Abstract

Objective

As part of patient-centered care, shared decision making (SDM)—where healthcare professionals (HCPs) and patients collaboratively choose treatments based on medical evidence and patient preferences—is essential for patients with multimorbidity facing varied benefits and risks. However, there is no clear conceptual understanding of what it represents. This study aims to analyze SDM concept for individuals with multimorbidity, clarifying key elements and guiding effective patient engagement in complex care decisions.

Methods

A concept analysis was undertaken using Walker and Avant's approach based on a literature review.

Results

SDM is a fundamental concept in health promotion for people with multimorbidity, assisting patients and HCPs in defining priorities, making choices, developing strategies, and executing them to improve health. Four core attributes were identified: (1) partnership based on mutual trust; (2) multidimensional information exchange; (3) complex trade-offs; (4) iterative communication and evaluation. Antecedents were divided into factors (complexity of diseases and multiple health needs from patients; communication skills from HCPs; consultation time, training and policy from health system). Consequences included patient autonomy and improved decision-making quality, patient satisfaction and symptom relief, and efficient utilization of medical resources.

Conclusions

Our findings offer insights into refining the concept of SDM in the context of multimorbidity. This concept analysis serves as a foundation for instrument development to measure the effects or attributes of the concept and highlights the need for future practical research on SDM that goes beyond involvement and engagement.

Practice implications

To implement SDM effectively for multimorbid patients, healthcare systems should enhance HCPs' communication skills, allocate sufficient consultation time to address complex needs, support SDM through policy, and develop tools to assess decision quality, patient satisfaction, and medical resource utilization.

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.