Patient experiences of shared decision-making following a displaced collarbone injury: A qualitative interview study.

Abstract

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.