Spine surgeon, patient perceptions of shared decision-making differ greatly: study

Alan Condon -  

Patients and spine surgeons have different perceptions when it comes to shared decision-making on surgery, according to a study published May 15 in Spine.

The study was based on interviews with five spine surgeons and six patients who were undergoing spinal deformity procedures. Researchers highlighted four patient themes and four surgeon themes:

Patients

1. Felt surgery was their only choice because they were running out of time to undergo invasive procedures.

2. Mentally committed to surgery prior to the initial visit with their surgeon and contextualized the desired benefits while minimizing the potential risks.

3. Felt decision support tools were ineffective in preparing them for surgery.

4. Felt pain management was the most difficult part of recovery from surgery.

Surgeons

1. Varied substantially in their interpretations of shared decision-making.

2. Did not consider patients' age as a major contraindication to have surgery.

3. Felt patient expectations from surgery were often established prior to their initial surgery visit, and frequently required recalibration.

4. A goal mismatch was noted between patients and surgeons in the desired outcomes of surgery: patients prioritize complete pain relief and surgeons prioritize concrete functional improvement.

"Older adult patients viewed the decision to have surgery as time-sensitive, whereas spine surgeons expressed the need for recalibrating patient expectations and balancing the risks and benefits when considering surgery," the researchers wrote. "These findings highlight the need for improved understanding of both sides of shared decision-making which should involve the needs and priorities of older adults to help convey patient-specific risks and choice awareness."

Click here for more information on this study.

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