Patient Education and Counseling最新文献

{"title":"Active and direct patient participation in health professions education: A narrative overview of literature from the global south","authors":"Ayesha Jawwad ,&nbsp;Zareen Zaidi ,&nbsp;Subha Ramani ,&nbsp;Herman E. Popeijus ,&nbsp;Marjan Govaerts","doi":"10.1016/j.pec.2025.108734","DOIUrl":"10.1016/j.pec.2025.108734","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients traditionally played a passive role in health professions education (HPE). However, their active involvement is increasingly valued, particularly in higher-resourced regions of the world known as the Global North. This study explores active and direct patient involvement in HPE contexts in the Global South (GS) regions of the world.</div></div><div><h3>Methods</h3><div>A narrative review of literature was conducted, utilising a systematic search of multiple electronic databases. 3966 abstracts were identified, and 80 full texts were reviewed. Ultimately, five papers were included in the final corpus.</div></div><div><h3>Results</h3><div>The selected studies were set in five GS countries, involving undergraduate, postgraduate medical and pharmacy training. Real patients, their caregivers and standardized patients acted as teachers or assessors focusing on learners' history-taking, communication skills, and professionalism. Challenges included cultural sensitivity and safety concerns, e.g. during home visits. Educators faced difficulties in patient recruitment, training and compensation.</div></div><div><h3>Conclusion &amp; practice implications</h3><div>Active and direct patient involvement in HPE within GS contexts remains limited. Current efforts focus on patients as teachers or assessors, with little contribution to educational design, instruction and mentoring. Educators may be overlooking the potential of diverse cultural perspectives to enhance patient engagement in HPE, making this a valuable area for future research.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108734"},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the state of shared decision-making in head and neck oncology: Assessing treatment communication","authors":"Anne N. Heirman ,&nbsp;Song L.L. Duimel ,&nbsp;Roosmarijn S. Tellman ,&nbsp;Richard Dirven ,&nbsp;Annemiek J. Linn ,&nbsp;Gyorgy B. Halmos ,&nbsp;Rob J.J.H. van Son ,&nbsp;Lisette van der Molen ,&nbsp;Alfons J.M. Balm ,&nbsp;Julia C.M. van Weert ,&nbsp;Michiel W.M. van den Brekel","doi":"10.1016/j.pec.2025.108733","DOIUrl":"10.1016/j.pec.2025.108733","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the state of shared decision-making (SDM) in head and neck (HN) oncology by investigating the extent to which SDM is currently employed by HN surgeons and how the perceived levels of SDM relate to the observed levels of SDM. Additionally, surgeon and patient perspectives on patient involvement in SDM and potential associations with observed levels of SDM were explored.</div></div><div><h3>Methods</h3><div>Perceived level of SDM and patient involvement were measured by SDM-Q-9/SDM-Q-Doc resp. Control Preference Scale. Observed SDM was measured by analyzing audiotaped consultations (N = 42) using the OPTION^mcc+ instrument. Univariate linear analyses were conducted to identify possible associations with surgeon-observed SDM.</div></div><div><h3>Results</h3><div>Median perceived SDM scores of surgeons (74.4 %) and patients (71.1 %) were relatively high, whereas observed median OPTION-scores were moderate (surgeons 48 %, patients 42 %, caregivers 24 %). Consultation time and patient OPTION-score were positively associated with surgeon OPTION-score.</div></div><div><h3>Conclusion</h3><div>Surgeons and patients seem to overestimate the extent of SDM compared to the observed reality. Patients’ goals, values and preferences need to be addressed more during consultations.</div></div><div><h3>Practice Implications</h3><div>The findings can be used to raise awareness of SDM among surgeons to improve their skills. Routine training in medical education can benefit from effective integration of SDM principles during consultations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108733"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating a Choosing Wisely leaflet supporting the reduction of imaging usage in low back pain management – A multi-method study","authors":"Chris Djurtoft ,&nbsp;Edel O'Hagan ,&nbsp;Monika Deleuran Laursen ,&nbsp;Lars Lejbølle ,&nbsp;Mia Bisgaard Jensen ,&nbsp;Simon Kristoffer Johansen ,&nbsp;Kristian Damgaard Lyng ,&nbsp;Morten Hoegh ,&nbsp;Negar Pourbordbari ,&nbsp;Malene Kjær Bruun ,&nbsp;Bettina Eiger ,&nbsp;Jesper Bie Larsen ,&nbsp;Michael Skovdal Rathleff","doi":"10.1016/j.pec.2025.108730","DOIUrl":"10.1016/j.pec.2025.108730","url":null,"abstract":"<div><h3>Objective</h3><div>The objective was to co-create an information resource in the form of a leaflet, to be distributed in clinical settings, websites or social media targeting people with low back pain.</div></div><div><h3>Methods</h3><div>This multi-method study was conducted in four stages: literature search, input from practice consultants, program theory development, and think-aloud interviews with people experiencing low back pain. Each stage was followed by a consensus meeting in which the steering group refined the leaflet based on the emerging knowledge.</div></div><div><h3>Results</h3><div>The literature search highlighted patients' need for easy-to-understand information about their back pain diagnosis, management strategies, social activities, work and solutions for supported self-management strategies. Practice consultants emphasized concise, relatable content. The program theory identified potential mechanisms for content creation, development, and implementation of the leaflet, such as addressing patient concerns, reducing diagnostic uncertainty, insights into management options, and validation. Think-aloud interviews with 18 people living with low back pain informed the iteration of the leaflet, enhancing language clarification and content comprehension.</div></div><div><h3>Conclusions</h3><div>We co-created a new <em>Choosing Wisely</em> leaflet, created with end-users in mind, specifically focused on reducing unnecessary imaging for low back pain.</div></div><div><h3>Practice implications</h3><div>This leaflet may support clinical settings in delivering evidence-based approaches and supporting self-management.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108730"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real needs of end-stage kidney disease patients awaiting kidney transplantation in China: A qualitative study","authors":"Menglin Yuan ,&nbsp;Xin Zhou ,&nbsp;Rui Luo ,&nbsp;Jiaao Lou ,&nbsp;Qifa Ye ,&nbsp;Xiaoyan Chen ,&nbsp;Bilong Feng","doi":"10.1016/j.pec.2025.108717","DOIUrl":"10.1016/j.pec.2025.108717","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the true needs of patients awaiting kidney transplantation in China through the language used by them. We addressed the literature gap concerning this critical aspect of patient care and counselling.</div></div><div><h3>Methods</h3><div>We interviewed 32 individuals—22 who were on the waiting list for a kidney transplant and 10 were kidney transplant recipients. The obtained data were analysed using Colaizzi seven-step method.</div></div><div><h3>Results</h3><div>Four themes encompassing 86 coded statements were identified and crosschecked with each participant for validation.The waiting period needs of the participants fell into four distinct categories: emotional support, informational, medical support, and social support needs.</div></div><div><h3>Conclusion</h3><div>We can determine the needs of patients by interpreting their linguistic cues with a nuanced understanding.Transplant professionals must (1) understand patients’ needs from their perspective; (2) recognise the dynamic changes in their emotional support demands; and (3) determine each patient’s informational needs, their willingness to receive medical support, and the current state of their social support.</div></div><div><h3>Practice Implications</h3><div>Our results offer insights for transplant professionals to better support patients awaiting kidney transplantation, highlighting the need to routinely attend to their unmet emotional, informational, medical and social support needs. This will enable patients to better prepare for transplantation while anticipating the arrival of a matched kidney.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108717"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A theory-based educational intervention to increase mothers’ intention to vaccinate their daughters against human papillomavirus: A randomised controlled trial","authors":"Areej Alqethami ,&nbsp;Eman Alhalal","doi":"10.1016/j.pec.2025.108731","DOIUrl":"10.1016/j.pec.2025.108731","url":null,"abstract":"<div><h3>Objective</h3><div>The current study aimed to examine the effectiveness of a web-based educational intervention based on the theory of planned behaviour (TPB) in enhancing mothers’ knowledge of human papillomavirus (HPV) and its vaccine, attitudes towards the HPV vaccine, subjective norms, perceived behavioural control, and intention to vaccinate their daughters against HPV.</div></div><div><h3>Method</h3><div>A randomised controlled trial was conducted. The sample comprised 214 mothers of adolescents from 10 intermediate schools in Saudi Arabia. After collecting baseline data, the participants were randomly assigned to control and intervention groups. The TPB-based intervention was delivered online to the intervention group, and post-test data were collected from both groups. A mixed-effects model of covariance was used to test the effect of the intervention.</div></div><div><h3>Results</h3><div>There were no significant differences between the two groups at baseline. One month after delivery, the intervention was found to have a significant effect on mothers’ knowledge (F (1, 211.15) = 72.40, <em>p</em> &lt; .001), attitudes (F (1, 211.11) = 110.57, <em>p</em> &lt; .001), subjective norms (F (1, 211) = 34.55, <em>p</em> &lt; .001), perceived control behaviour (F (1, 211.12) = 144.01, <em>p</em> &lt; .001), and intention to vaccinate their daughters against HPV (F (1, 211.05) = 113.64, <em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The study showed that the web-based intervention based on the TPB was effective in increasing mothers’ knowledge, attitude, subjective norms, perceived control behaviour, and intention to vaccinate their daughters after 1 month.</div></div><div><h3>Practice implications</h3><div>The findings underscore the significance of popularising and implementing such interventions to boost HPV vaccine coverage among adolescents.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108731"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising invitation and advance notification letters to increase bowel cancer screening participation: A qualitative analysis","authors":"Katelyn Collins ,&nbsp;Michael Ireland ,&nbsp;Laura Anderson ,&nbsp;Carlene Wilson ,&nbsp;Natalie Taylor ,&nbsp;Bianca Viljoen ,&nbsp;Mark Jenkins ,&nbsp;Belinda Goodwin","doi":"10.1016/j.pec.2025.108729","DOIUrl":"10.1016/j.pec.2025.108729","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore how letters distributed in population bowel cancer screening programmes could be modified to increase bowel cancer screening uptake, from the perspective of screening invitees.</div></div><div><h3>Methods</h3><div>Sixty-three people aged 48–74 years discussed their preferences regarding letter design and content during semi-structured interviews aided by various example letters designed to notify of, or invite participants to, the Australian National Bowel Cancer Screening Programme (NBCSP). Deductive thematic analysis, informed by the Integrated Screening Action Model (I-SAM), was used to interpret participant feedback and provide recommendations for improvements to the letters in alignment with the theoretical stages of bowel cancer screening behaviour (engaging, deciding, and completing the screening kit).</div></div><div><h3>Results</h3><div>Participants generally agreed that effective letters should feature a clear, eye-catching design to enhance initial engagement. Messages targeting emotional barriers and content tailored to prior screening history were seen as crucial to drive screening decision-making. Finally, step-by-step instructions, deadlines, and reminders were identified as facilitators of kit completion, bridging the gap between intention and action.</div></div><div><h3>Conclusions</h3><div>The findings of this study align with the I-SAM framework for understanding the progression of screening behaviours and highlight key design elements that can enhance the effectiveness of bowel cancer screening invitations. The design and messaging within screening letters has the potential to address common concerns and encourage screening participation.</div></div><div><h3>Practice implications</h3><div>The simplification of letter design, and integration of tailored messaging strategies, simple kit instructions, reminders, and deadlines could boost engagement and help bridge the intention-behaviour gap, driving increased screening participation.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108729"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining telephone and online channels: Experiences of the Dutch STI sex information helpline","authors":"Filippo Zimbile ,&nbsp;Marjan Mientjes ,&nbsp;Silke David ,&nbsp;Rik Crutzen","doi":"10.1016/j.pec.2025.108728","DOIUrl":"10.1016/j.pec.2025.108728","url":null,"abstract":"<div><h3>Introduction</h3><div>The Dutch STI Sex Information Helpline has gradually expanded its telephone services to include online services via email and online chat. In addition, a thematic broadening of AIDS and HIV-related support took place, covering almost all Sexual and Reproductive Health and Rights topics. Since 2015, the helpline collaborates closely with public sexual health clinics' nurses to provide online chat-services.</div></div><div><h3>Objectives</h3><div>This article explores similarities and differences among callers, emailers, and chatters, including their background characteristics, reasons for contact, characteristics of the contacts, satisfaction with the service, and channel preferences. Furthermore, it describes how nurses evaluate national cooperation in the online chat-service and the added value they perceive in relation to their work at the public sexual health clinics.</div></div><div><h3>Methods</h3><div>In this mixed method cross-sectional design study registration data of the Helpline of 2018 (N = 17.585) is analysed in combination with analyses of a client satisfaction study among users of all three channels in 2018 (N = 488). In addition, an online evaluation survey was conducted among nurses who participate in the online chat-service in 2022 (N = 35).</div></div><div><h3>Results</h3><div>This study shows that online chat is the most frequently used channel, yet there is substantial demand for email and telephone services. Channel selection depends on the background characteristics of clients, the content of the help request and personal preferences and needs. Users equally rate all channels positively. Nurses assess their participation in the chat-service as an added value to their work in the clinics and endorse the importance of national cooperation.</div></div><div><h3>Conclusions</h3><div>Offering sexual health information services via phone, online chat, and email allows a helpline to serve a diverse public. Despite online chat being the most popular, usage and satisfaction is high across all channels, indicating effective user choice. A mix of channels does not only extends a helpline's reach, it also enhances the accessibility of public sexual health care through its connecting role.</div></div><div><h3>Practical implications</h3><div>While online chat is popular, it also consumes a considerable amount of professionals' time. This requires an efficient strategy for offering the three channels in a coherent manner.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108728"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to shared decision making: A qualitative study of families who delivered at the cusp of viability","authors":"Katarina S. Schneiderman ,&nbsp;Alexa P. Henderson ,&nbsp;Katherine P. Himes","doi":"10.1016/j.pec.2025.108715","DOIUrl":"10.1016/j.pec.2025.108715","url":null,"abstract":"<div><h3>Objectives</h3><div>There is limited data regarding patients’ experiences with periviable counseling. Exploring patient perspectives helps us improve provider communication and may aid in supporting high-quality decision-making. Our study explored patient-identified sources of support and conflict during discussions with their healthcare team when delivering during the periviable period with the goal of improving high-quality shared decision making (SDM).</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews of birthing people who delivered between 20 0/7 and 25 6/7 weeks gestational age from 2010 to 2014. Interviews focused on shared decision making at the time of periviable birth with an emphasis on the three-talk model of SDM. Interviews were coded to perform thematic analysis<u>.</u></div></div><div><h3>Results</h3><div>We interviewed 20 patients who delivered during the periviable period and 6 important others. Participants valued providers aiding in their emotional processing. Conversely, participants identified lack of clarity during counseling and an emphasis on hopelessness as barriers to SDM.</div></div><div><h3>Conclusion(s)</h3><div>Participants highlighted the importance of using easy-to-understand language and focusing on hope. Finally, families emphasized the importance of explicitly eliciting values that might inform their choice and the positive impact of nursing staff.</div><div>Practice Implications: Our findings underscore the importance of using a SDM model for periviability counseling and highlight areas for improvement.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108715"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of observational coding systems to assess patient-healthcare professional interactions","authors":"Marij A. Hillen ,&nbsp;Kerri-Anne R. Mitchell ,&nbsp;Barbara C. Schouten ,&nbsp;John W. Cyrus ,&nbsp;Richard F. Brown ,&nbsp;Arwen H. Pieterse","doi":"10.1016/j.pec.2025.108718","DOIUrl":"10.1016/j.pec.2025.108718","url":null,"abstract":"<div><h3>Objectives</h3><div>Systematic coding is used to study interactions between patients and healthcare professionals from an independent observer perspective. Many coding systems are available, but an up-to-date overview is lacking. We aimed to: (1) provide a comprehensive overview of systems for systematic coding of patient-healthcare professional interactions; and describe their 2) general characteristics and development, and 3) validation and adaptation.</div></div><div><h3>Methods</h3><div>We systematically searched peer-reviewed empirical articles in five databases (Cochrane, Embase, PubMed/Medline, CINAHL, PsychINFO) using variations of the following keywords: (i) patient and/or other stakeholder, (ii) healthcare professional (iii), interactions in healthcare, (iv) coding tool, and (v) development and/or validation. All titles/abstracts and full-texts were screened independently and in duplicate. Additionally, coding systems were identified through an earlier review, an open-access research database, and a forward-reference search of all included coding systems up to that point. For all eligible systems, we extracted characteristics and psychometric properties.</div></div><div><h3>Results</h3><div>From a total of 6950 identified articles from literature databases, 188 full-text articles were screened. Thirty-five articles were included from additional sources. In total, we included 124 articles describing 98 coding systems. Systems were highly variable in terms of topic (e.g., patient-centered communication, shared decision making, behavior change counseling), clinical context (e.g., oncology, pediatrics, generic), rigor of development and reporting, coding complexity, and extent of psychometric testing. Inter-rater reliability was reported for most coding systems; only few were tested for other types of reliability or for validity.</div></div><div><h3>Conclusions</h3><div>A plethora of coding systems are available, but more systematic reporting and psychometric testing are urgently needed to enhance evidence of validity. Testing may initially focus on the most relevant and broadly applicable coding systems.</div></div><div><h3>Practice implications</h3><div>These results can aid researchers in selecting the most suitable coding system for their purposes. Researchers may consider using or adapting existing systems, before developing new coding systems.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108718"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared decision making for people living with multimorbidity: A concept analysis","authors":"Shupeng Shi ,&nbsp;Xingzhou Liu ,&nbsp;Yongjie Li ,&nbsp;Chuan Yang","doi":"10.1016/j.pec.2025.108712","DOIUrl":"10.1016/j.pec.2025.108712","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>A concept analysis was undertaken using Walker and Avant's approach based on a literature review.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Practice implications</h3><div>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.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108712"},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}