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 language | English (US) |
|---|---|
| Pages (from-to) | 192-202 |
| Number of pages | 11 |
| Journal | Topics in spinal cord injury rehabilitation |
| Volume | 22 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jan 1 2016 |
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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
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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 journal › Review 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
UR - http://www.scopus.com/inward/record.url?scp=84986887887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84986887887&partnerID=8YFLogxK
U2 - 10.1310/sci2016-00027
DO - 10.1310/sci2016-00027
M3 - Review article
C2 - 29339861
AN - SCOPUS:84986887887
VL - 22
SP - 192
EP - 202
JO - Topics in Spinal Cord Injury Rehabilitation
JF - Topics in Spinal Cord Injury Rehabilitation
SN - 1082-0744
IS - 3
ER -