Perceptions of shared decision making among patients with spinal cord injuries/disorders

Sara M. Locatelli*, Bella Etingen, Allen Walter Heinemann, Holly De Mark Neumann, Ana Miskovic, David Chen, Sherri L LaVela

*Corresponding author for this work

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Background: Individuals with spinal cord injuries/disorders (SCI/D) are interested in, and benefit from, shared decision making (SDM). Objective: To explore SDM among individuals with SCI/D and how demographics and health and SCI/D characteristics are related to SDM. Method: Individuals with SCI/D who were at least 1 year post injury, resided in the Chicago metropolitan area, and received SCI care at a Veterans Affairs (VA; n = 124) or an SCI Model Systems facility (n = 326) completed a mailed survey measuring demographics, health and SCI/D characteristics, physical and mental health status, and perceptions of care, including SDM, using the Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness (COMRADE) that assesses decision-making effectiveness (effectiveness) and risk communication (communication). Bivariate analyses and multiple linear regression were used to identify variables associated with SDM. Results: Participants were mostly male (83%) and White (70%) and were an average age of 54 years (SD = 14.3). Most had traumatic etiology, 44% paraplegia, and 49% complete injury. Veteran/civilian status and demographics were unrelated to scores. Bivariate analyses showed that individuals with tetraplegia had better effectiveness scores than those with paraplegia. Better effectiveness was correlated with better physical and mental health; better communication was correlated with better mental health. Multiple linear regressions showed that tetraplegia, better physical health, and better mental health were associated with better effectiveness, and better mental health was associated with better communication. Conclusion: SCI/D and health characteristics were the only variables associated with SDM. Interventions to increase engagement in SDM and provider attention to SDM may be beneficial, especially for individuals with paraplegia or in poorer physical and mental health.

Original languageEnglish (US)
Pages (from-to)192-202
Number of pages11
JournalTopics in spinal cord injury rehabilitation
Volume22
Issue number3
DOIs
StatePublished - Jan 1 2016

Fingerprint

Spinal Cord Diseases
Spinal Cord Injuries
Decision Making
Mental Health
Communication
Paraplegia
Quadriplegia
Demography
Veterans
Linear Models
Health
Wounds and Injuries
Health Status
Outcome Assessment (Health Care)

Keywords

  • Decision making
  • Patient-centered care
  • Physician-patient relations
  • Spinal cord injuries

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

Cite this

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title = "Perceptions of shared decision making among patients with spinal cord injuries/disorders",
abstract = "Background: Individuals with spinal cord injuries/disorders (SCI/D) are interested in, and benefit from, shared decision making (SDM). Objective: To explore SDM among individuals with SCI/D and how demographics and health and SCI/D characteristics are related to SDM. Method: Individuals with SCI/D who were at least 1 year post injury, resided in the Chicago metropolitan area, and received SCI care at a Veterans Affairs (VA; n = 124) or an SCI Model Systems facility (n = 326) completed a mailed survey measuring demographics, health and SCI/D characteristics, physical and mental health status, and perceptions of care, including SDM, using the Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness (COMRADE) that assesses decision-making effectiveness (effectiveness) and risk communication (communication). Bivariate analyses and multiple linear regression were used to identify variables associated with SDM. Results: Participants were mostly male (83{\%}) and White (70{\%}) and were an average age of 54 years (SD = 14.3). Most had traumatic etiology, 44{\%} paraplegia, and 49{\%} complete injury. Veteran/civilian status and demographics were unrelated to scores. Bivariate analyses showed that individuals with tetraplegia had better effectiveness scores than those with paraplegia. Better effectiveness was correlated with better physical and mental health; better communication was correlated with better mental health. Multiple linear regressions showed that tetraplegia, better physical health, and better mental health were associated with better effectiveness, and better mental health was associated with better communication. Conclusion: SCI/D and health characteristics were the only variables associated with SDM. Interventions to increase engagement in SDM and provider attention to SDM may be beneficial, especially for individuals with paraplegia or in poorer physical and mental health.",
keywords = "Decision making, Patient-centered care, Physician-patient relations, Spinal cord injuries",
author = "Locatelli, {Sara M.} and Bella Etingen and Heinemann, {Allen Walter} and Neumann, {Holly De Mark} and Ana Miskovic and David Chen and LaVela, {Sherri L}",
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pages = "192--202",
journal = "Topics in Spinal Cord Injury Rehabilitation",
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Perceptions of shared decision making among patients with spinal cord injuries/disorders. / Locatelli, Sara M.; Etingen, Bella; Heinemann, Allen Walter; Neumann, Holly De Mark; Miskovic, Ana; Chen, David; LaVela, Sherri L.

In: Topics in spinal cord injury rehabilitation, Vol. 22, No. 3, 01.01.2016, p. 192-202.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Perceptions of shared decision making among patients with spinal cord injuries/disorders

AU - Locatelli, Sara M.

AU - Etingen, Bella

AU - Heinemann, Allen Walter

AU - Neumann, Holly De Mark

AU - Miskovic, Ana

AU - Chen, David

AU - LaVela, Sherri L

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Individuals with spinal cord injuries/disorders (SCI/D) are interested in, and benefit from, shared decision making (SDM). Objective: To explore SDM among individuals with SCI/D and how demographics and health and SCI/D characteristics are related to SDM. Method: Individuals with SCI/D who were at least 1 year post injury, resided in the Chicago metropolitan area, and received SCI care at a Veterans Affairs (VA; n = 124) or an SCI Model Systems facility (n = 326) completed a mailed survey measuring demographics, health and SCI/D characteristics, physical and mental health status, and perceptions of care, including SDM, using the Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness (COMRADE) that assesses decision-making effectiveness (effectiveness) and risk communication (communication). Bivariate analyses and multiple linear regression were used to identify variables associated with SDM. Results: Participants were mostly male (83%) and White (70%) and were an average age of 54 years (SD = 14.3). Most had traumatic etiology, 44% paraplegia, and 49% complete injury. Veteran/civilian status and demographics were unrelated to scores. Bivariate analyses showed that individuals with tetraplegia had better effectiveness scores than those with paraplegia. Better effectiveness was correlated with better physical and mental health; better communication was correlated with better mental health. Multiple linear regressions showed that tetraplegia, better physical health, and better mental health were associated with better effectiveness, and better mental health was associated with better communication. Conclusion: SCI/D and health characteristics were the only variables associated with SDM. Interventions to increase engagement in SDM and provider attention to SDM may be beneficial, especially for individuals with paraplegia or in poorer physical and mental health.

AB - Background: Individuals with spinal cord injuries/disorders (SCI/D) are interested in, and benefit from, shared decision making (SDM). Objective: To explore SDM among individuals with SCI/D and how demographics and health and SCI/D characteristics are related to SDM. Method: Individuals with SCI/D who were at least 1 year post injury, resided in the Chicago metropolitan area, and received SCI care at a Veterans Affairs (VA; n = 124) or an SCI Model Systems facility (n = 326) completed a mailed survey measuring demographics, health and SCI/D characteristics, physical and mental health status, and perceptions of care, including SDM, using the Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness (COMRADE) that assesses decision-making effectiveness (effectiveness) and risk communication (communication). Bivariate analyses and multiple linear regression were used to identify variables associated with SDM. Results: Participants were mostly male (83%) and White (70%) and were an average age of 54 years (SD = 14.3). Most had traumatic etiology, 44% paraplegia, and 49% complete injury. Veteran/civilian status and demographics were unrelated to scores. Bivariate analyses showed that individuals with tetraplegia had better effectiveness scores than those with paraplegia. Better effectiveness was correlated with better physical and mental health; better communication was correlated with better mental health. Multiple linear regressions showed that tetraplegia, better physical health, and better mental health were associated with better effectiveness, and better mental health was associated with better communication. Conclusion: SCI/D and health characteristics were the only variables associated with SDM. Interventions to increase engagement in SDM and provider attention to SDM may be beneficial, especially for individuals with paraplegia or in poorer physical and mental health.

KW - Decision making

KW - Patient-centered care

KW - Physician-patient relations

KW - Spinal cord injuries

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U2 - 10.1310/sci2016-00027

DO - 10.1310/sci2016-00027

M3 - Review article

C2 - 29339861

AN - SCOPUS:84986887887

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JO - Topics in Spinal Cord Injury Rehabilitation

JF - Topics in Spinal Cord Injury Rehabilitation

SN - 1082-0744

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