Publication date

Using interventions with patients before clinical encounters to encourage their participation.

Faber, M.J., Dulmen, S. van, Kinnersley, P. Using interventions with patients before clinical encounters to encourage their participation. In: G. Elwyn, A.Edwards, R. Thompson (eds). Shared Decision Making in Health Care: achieving evidence-based patient choice. 3rd Edition. Oxford University Press, 2016. This publication can be found on the publisher's website.
lntroduction to interventions with patients before clinical encounters

After clinical encounters patients often report that they feel uninformed, not only because they receive too little information, but also because the information provided does not address their specific information needs or may be difficult to understand. Failure to give patients the information they need may increase emotional distress and hamper any further benefits from active patient involvement in the encounter and care processes such as symptom relief or treatment adherence.

Three categories of reasons are known to limit the amount and quality of information transfer during the encounter. First, factors related to the physician: for example, doctors ignore or misinterpret patients' information needs, lack the skills to communicate effectively, overestimate the amount of information they have provided, and use technical and non-specific terminology, Second, the mode of information transfer can hamper effectiveness, such as spoken versus written versus pictograms. Third, factors related to patients need to be considered, including health, literacy skills, and anxiety levels. Moreover, patients refrain from asking questions as they may feel they are being difficult' when asking too much, perceive that there is no time for questions, and only remember their questions after leaving the room.

Patients themselves can be a very powerful source for change: they can monitor their health problems and needs for care, document the information they require, and report this during their contact with the care provider. Such strategies may help to identify issues that could otherwise go unnoticed or unmentioned, This chapter summarizes what clinicians need to know about pre-encounter tools that are available outside the clinical office for patients to help them get the information they require during the encounter.