Moderators and Mediators of the Relationship of Shared Decision-Making and Satisfaction

Background:Evidence suggests that health literacy, perceived availability of information and guidance to adapt to challenges (informational support), and symptoms of depression all have the potential to mediate or moderate the relationship between patient-rated involvement in decisions and satisfaction with care. If so these could be useful targets for improving patient experience. Methods: We prospectively enrolled 130 new adult patients visiting an orthopedic surgeon over a 4-month period. All patients were asked to complete measures of satisfaction with care (21-item Medical Interview Satisfaction Scale), perceived involvement in decisions (9-item Shared Decision-Making Questionnaire), symptoms of depression (the Patient-Reported Outcomes Measurement Information Scale [PROMIS] Depression Computerized Adaptive Test [CAT]), perceived availability of information and guidance to adapt to challenges (PROMIS Informational Support CAT), and the Newest Vital Sign test of health literacy. Results: The strong correlation between satisfaction with care (ρ = 0.60, P < .001) and perceived involvement in decisions was neither mediated nor moderated by health literacy, perceived availability of information and guidance, and symptoms of depression. Conclusions: The observation that patient-rated shared decision-making is strongly related to satisfaction with an office visit, independent of health literacy, perceived support, and symptoms of depression, is consistent with evidence that various measures of patient experience tend to correlate and emphasizes the importance of the patient–clinician relationship. Level of Evidence: Level II, prospective study.

[1]  Charles D. Wilson,et al.  A Systematic Review of Satisfaction Measures in Hand and Wrist Surgery. , 2022, The Journal of hand surgery.

[2]  N. Kazmers,et al.  The Impact of Social Deprivation on Orthopaedic Outpatient Satisfaction Using the Press Ganey Outpatient Medical Practice Survey. , 2020, The Journal of the American Academy of Orthopaedic Surgeons.

[3]  N. Kazmers,et al.  Evaluating opportunities for improved orthopedics outpatient satisfaction: an analysis of Press Ganey® Outpatient Medical Practice Survey responses , 2020, Journal of Orthopaedic Surgery and Research.

[4]  Joseph Johnson,et al.  Marriage Status Predicts Hospital Outcomes Following Orthopedic Trauma , 2020, Geriatric orthopaedic surgery & rehabilitation.

[5]  K. Bozic,et al.  Value-based Healthcare: Improving Outcomes through Patient Activation and Risk Factor Modification. , 2019, Clinical orthopaedics and related research.

[6]  C. Keijsers,et al.  Fewer patients undergo surgery when adding a comprehensive geriatric assessment in older patients with a hip fracture , 2019, Archives of Orthopaedic and Trauma Surgery.

[7]  D. Ring,et al.  Delayed hospital discharge after total shoulder arthroplasty: why, and who is at risk? , 2019, JSES open access.

[8]  Samprit Banerjee,et al.  Effectiveness of Shared Decision-Making for Elderly Depressed Minority Primary Care Patients. , 2019, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[9]  T. Pawlik,et al.  Association of Income Disparities with Patient-Reported Healthcare Experience , 2019, Journal of General Internal Medicine.

[10]  J. Bae,et al.  Preoperative predictors of patient satisfaction after carpal tunnel release. , 2018, Orthopaedics & traumatology, surgery & research : OTSR.

[11]  S. Lim,et al.  Depressive Symptoms Are Associated With Low Treatment Adherence in African American Individuals With Systemic Lupus Erythematosus , 2018, Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.

[12]  B. Weiss.  The Newest Vital Sign: Frequently Asked Questions , 2018, Health literacy research and practice.

[13]  S. Ibrahim,et al.  Military Service and Decision Quality in the Management of Knee Osteoarthritis. , 2018, Military medicine.

[14]  W. Chou,et al.  Relationship between the social support and self-efficacy for function ability in patients undergoing primary hip replacement , 2018, Journal of Orthopaedic Surgery and Research.

[15]  Howard Cabral,et al.  Patient Activation Mediates Health Literacy Associated with Hospital Utilization Among Whites , 2017, Health literacy research and practice.

[16]  M. Härter,et al.  Use of the 9-item Shared Decision Making Questionnaire (SDM-Q-9 and SDM-Q-Doc) in intervention studies—A systematic review , 2017, PloS one.

[17]  J. Slover,et al.  Current concepts of shared decision making in orthopedic surgery , 2017, Current Reviews in Musculoskeletal Medicine.

[18]  T. Bickmore,et al.  Health Literacy and Education as Mediators of Racial Disparities in Patient Activation Within an Elderly Patient Cohort , 2016, Journal of health care for the poor and underserved.

[19]  Kayce M. Shealy,et al.  Utilization of the Newest Vital Sign (NVS) in Practice in the United States , 2016, Health communication.

[20]  D. Ring,et al.  Patient Satisfaction and its Relation to Perceived Visit Duration With a Hand Surgeon. , 2016, The Journal of hand surgery.

[21]  T. Ryken,et al.  Preoperative Depression, Smoking, and Employment Status are Significant Factors in Patient Satisfaction After Lumbar Spine Surgery , 2015, Clinical spine surgery.

[22]  A. Vranceanu,et al.  What Is the Most Useful Questionnaire for Measurement of Coping Strategies in Response to Nociception? , 2015, Clinical orthopaedics and related research.

[23]  J. Andrawis,et al.  Higher Preoperative Patient Activation Associated With Better Patient-reported Outcomes After Total Joint Arthroplasty , 2015, Clinical orthopaedics and related research.

[24]  A. Vranceanu,et al.  Informed shared decision-making and patient satisfaction. , 2014, Psychosomatics.

[25]  H. Reuveni,et al.  Patient activation, depression and quality of life. , 2014, Patient education and counseling.

[26]  Daniel J Buysse,et al.  The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. , 2010, Journal of clinical epidemiology.

[27]  Lara M. Stepleman,et al.  Validation of the patient activation measure in a multiple sclerosis clinic sample and implications for care , 2010, Disability and rehabilitation.

[28]  A. Vranceanu,et al.  Integrating patient values into evidence-based practice: effective communication for shared decision-making. , 2009, Hand clinics.

[29]  B. Weiss,et al.  Quick Assessment of Literacy in Primary Care: The Newest Vital Sign , 2005, The Annals of Family Medicine.

[30]  J. Weinman,et al.  The 'Medical Interview Satisfaction Scale' (MISS-21) adapted for British general practice. , 2002, Family practice.

[31]  W. Stiles,et al.  The medical interview satisfaction scale: Development of a scale to measure patient perceptions of physician behavior , 1978, Journal of Behavioral Medicine.

[32]  D. Ring,et al.  Influence of Patient Activation, Pain Self-Efficacy, and Resilience on Pain Intensity and Magnitude of Limitations in Patients With Hip and Knee Arthritis. , 2019, Journal of surgical orthopaedic advances.

[33]  D. Ring,et al.  Patient satisfaction after open carpal tunnel release correlates with depression. , 2008, The Journal of hand surgery.

[34]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .