Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 12, 2020
Date Accepted: May 13, 2020
Shared decision making and patient-centered care in Israel, Jordan, and the US: An exploratory and comparative study of physician perceptions
ABSTRACT
Background:
Shared decision making (SDM) is a central model to support patient engagement in healthcare. SDM evolved in Europe and North America and is largely reflective of the values and medical practices dominant in western countries. Although SDM has become more widely discussed in recent years in non-western countries, less is known about how or whether attitudes, beliefs, and practices regarding patient-centered care exist or differ in various other regions of the world.
Objective:
To compare the beliefs, attitudes, and reported practices of physicians regarding SDM and patient-centered care (PCC) in the Middle East.
Methods:
A hypothesis-generating survey study about the beliefs, attitudes, and practices around SDM and PCC was administered to physicians from the Middle East and to a group of physicians from the US as a comparison.
Results:
A total of 34 surveys were collected via snowball sampling (Jordan n=15, US n=12, Israel n=7). SDM was perceived as a way to inform patients and allowing patient participation, decision, or approval about their care. Barriers for implementing SDM varied based on place of origin; while physicians in the US mentioned limited time, Jordan physicians reported that a lack of education of patients limits SDM practices and in Israel physicians reported lack of communication training. Most US physicians defined PCC as a practice to prioritize patient needs and preferences, while both Jordan and Israel physicians defined PCC as a holistic approach to care and prioritizing patient needs. Barriers to implementing PCC seen by US physicians were mostly centered on limited appointments time and insurance coverage. In Jordan and Israel, staff shortage and the lack of resources in the system were seen as major barriers for PCC implementation. Discussion and
Conclusions:
Our first and exploratory survey of physicians in the Middle East and the USA suggests that perceptions of PCC might widely differ among these regions, while concepts of SDM might be shared. Future work should both clarifies these differences. Clinical Trial: N/A
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