Moderators and Mediators of the Relationship of Shared Decision-Making and Satisfaction

Tom J Crijns; Paxton Segina; Joost T P Kortlever; Jacob E Thomas; David Ring; Lee Reichel; Gregg Vagner; Sina Ramtin

doi:10.1177/23743735231171563

Moderators and Mediators of the Relationship of Shared Decision-Making and Satisfaction

J Patient Exp. 2023 Apr 27:10:23743735231171563. doi: 10.1177/23743735231171563. eCollection 2023.

Authors

Tom J Crijns¹, Paxton Segina¹, Joost T P Kortlever¹, Jacob E Thomas¹, David Ring¹, Lee Reichel¹, Gregg Vagner¹, Sina Ramtin¹

Affiliation

¹ Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.

Abstract

Background:Evidence suggests that health literacy, perceived availability of information and guidance to adapt to challenges (informational support), and symptoms of depression all have the potential to mediate or moderate the relationship between patient-rated involvement in decisions and satisfaction with care. If so these could be useful targets for improving patient experience. Methods: We prospectively enrolled 130 new adult patients visiting an orthopedic surgeon over a 4-month period. All patients were asked to complete measures of satisfaction with care (21-item Medical Interview Satisfaction Scale), perceived involvement in decisions (9-item Shared Decision-Making Questionnaire), symptoms of depression (the Patient-Reported Outcomes Measurement Information Scale [PROMIS] Depression Computerized Adaptive Test [CAT]), perceived availability of information and guidance to adapt to challenges (PROMIS Informational Support CAT), and the Newest Vital Sign test of health literacy. Results: The strong correlation between satisfaction with care (ρ = 0.60, P < .001) and perceived involvement in decisions was neither mediated nor moderated by health literacy, perceived availability of information and guidance, and symptoms of depression. Conclusions: The observation that patient-rated shared decision-making is strongly related to satisfaction with an office visit, independent of health literacy, perceived support, and symptoms of depression, is consistent with evidence that various measures of patient experience tend to correlate and emphasizes the importance of the patient-clinician relationship. Level of Evidence: Level II, prospective study.

Keywords: health literacy; medical decision-making; patient satisfaction; shared decision-making.