Components | Elements | Frequency |
Advocate patient views | Patient advocacy | 12 (30%) |
Patient opinion is important | ||
Create choice awareness | Equipoise | 22 (55%) |
Make need for decision explicit | ||
Deliberate | Deliberation* | 23 (58%) |
Negotiation* | ||
Describe treatment options | Benefits/risks (pros/cons)† | 35 (88%) |
Feasibility of option(s) | ||
List options‡ | ||
Present evidence† | ||
Determine roles in decision making process | All parties have a legitimate interest in the decision† | 14 (35%) |
Formulation of equality of partners | ||
Involves at least two people† | ||
Patient's decisional role preference‡ | ||
Process determination or evaluation | ||
Determine next step | Arrange follow-up† | 19 (48%) |
Implementation | ||
Foster partnership | Mutual respect† | 12 (30%) |
Partnership† | ||
Gather support and information | Patient accesses information | 8 (20%) |
Support with decision | ||
Healthcare professional expertise | Doctor knowledge* | 4 (10%) |
Healthcare professional preferences | Healthcare professional preferences | 7 (18%) |
Healthcare professional values | ||
Learn about the patient | Check/clarify understanding healthcare professional‡ | 21 (53%) |
Learn about the patient | ||
Make the decision | Document (discussion about) decision | 30 (75%) |
Make or explicitly defer decision† | ||
Patient retains ultimate authority over decision | ||
Revisiting decision | ||
Offer time | Offer time | 8 (20%) |
Patient expertise | Patient expertise | 3 (8%) |
Patient preferences | Patient concerns | 26 (65%) |
Patient goals of care | ||
Patient preferences* | ||
Patient values* | ||
Patient questions | Patient questions | 8 (20%) |
Prepare | Prepare (prior to consultation) | 6 (15%) |
Provide information | Information exchange† | 17 (43%) |
Medical information | ||
Patient information | ||
Provide neutral information | Unbiased information† | 8 (20%) |
Provide recommendation | Doctor recommendation* | 10 (25%) |
Reach mutual agreement | Mutual agreement† | 14 (35%) |
Set agenda | Decide on agenda for the consultation | 9 (23%) |
Define/explain problem† | ||
Support decision making process | Assess what patient needs to make decision | 11 (28%) |
Doctor guidance in decision making process | ||
Identify and address emotions | ||
Tailor information | Ascertain preferred (format for) information† | 26 (65%) |
Check/clarify understanding patient‡ | ||
Flexibility/individualised approach† | ||
Use clear language |
*Split element from review Makoul & Clayman;5 the original element contained two different constituents.
†Original element from review Makoul & Clayman.5
‡Refined element from review Makoul & Clayman;5 we added the appropriate verb or relevant actor.