Antecedents and consequences of shared decision making for patients with chronic kidney diseases: A cross-sectional survey

Kuang-Ming Kuo; I-Chiu Chang; Chih-Ming Chen; Feng-Jung Yang

doi:10.1016/j.ijmedinf.2022.104898

Antecedents and consequences of shared decision making for patients with chronic kidney diseases: A cross-sectional survey

Int J Med Inform. 2022 Dec:168:104898. doi: 10.1016/j.ijmedinf.2022.104898. Epub 2022 Oct 17.

Authors

Kuang-Ming Kuo¹, I-Chiu Chang², Chih-Ming Chen³, Feng-Jung Yang⁴

Affiliations

¹ Department of Business Management, National United University, Miaoli, Taiwan, ROC. Electronic address: kuangmingkuo@gmail.com.
² Department of Information Management, National Chung Cheng University, Chiayi, Taiwan, ROC. Electronic address: misicc@mis.ccu.edu.tw.
³ Department of Information Management, National Chung Cheng University, Chiayi, Taiwan, ROC. Electronic address: jrming@htit.com.tw.
⁴ Department of Internal Medicine, National Taiwan University Hospital Yun Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu City, Taiwan, ROC. Electronic address: fongrong@ntu.edu.tw.

PMID: 36265361
DOI: 10.1016/j.ijmedinf.2022.104898

Abstract

Background: Chronic kidney disease (CKD) has a strong negative impact on patients. Finding ways to improve CKD patients' conditions by shared decision-making is receiving much attention. However, little attention has been paid to influencing antecedents and effects of shared decision-making. Meanwhile, as advanced technologies bring in new communication devices, effects of different types of communications used in shared decision-making need to be addressed.

Objective: This study proposes a research framework to determine the influencing antecedents of shared decision-making, and to evaluate the effects of shared decision-making on patient outcomes when they are computer-mediated and when the decision-makers communicate face-to-face.

Methods: A cross-section survey was conducted and a total of 48 valid samples were obtained. The participants were CKD Stage III, IV, or V patients who had received medical treatment in a hospital in Taiwan. The collected data were subjected to an independent t-test and partial least squares analysis to validate the research framework.

Results: Doctor-patient communication (DPC) and doctor-patient relationship (DPR) have no significant direct impact on patient outcomes. Nevertheless, both DPC and DPR significantly impact shared decision-making which in turn impacts patient outcomes. Moreover, patients who use computer-mediated communication were found to have significantly higher perceptions of shared decision-making than those who did not.

Conclusions: The incidence and prevalence of end-stage renal disease in Taiwan are among the highest in the world. The results of this study can serve as a reference for hospitals to improve CKD patients' outcomes. Meanwhile, during the COVID-19 pandemic, this study suggested hospitals should encourage shared decision-making with computer-mediated communication to ensure that patients receive proper treatment and have the desired outcomes.

Keywords: Doctor-patient communication; Doctor-patient relationship; Patient outcomes; Shared decision-making.

MeSH terms

COVID-19*
Communication
Cross-Sectional Studies
Decision Making
Decision Making, Shared
Humans
Pandemics
Patient Participation
Physician-Patient Relations
Renal Insufficiency, Chronic* / epidemiology
Renal Insufficiency, Chronic* / therapy