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Shared Decision-Making and the Lower Literate Patient

Published online by Cambridge University Press:  01 January 2021

David I. Shalowitz  and
Michael S. Wolf
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Extract

In recent years, shared decision-making has become entrenched in the medical literature and the law as the ideal method for involving patients in decisions related to their health care. Shared decision-making represents a compromise between the opposed extremes of paternalistic interactions that limit patients’ control of their health care, and “informed choice” interactions that require physicians to provide technical expertise only, leaving patients to make all treatment decisions on their own. An implicit goal of shared decision-making is to improve medical care by promoting joint participation of patients and physicians in clinical consultations. The model of shared decision-making may, however, inadequately address the health care needs of lower literate patients, a significant portion of the general population.

As shared decision-making is widely held as a clinical ideal, we highlight the difficulties that physicians might have in implementing shared decision-making with lower literate patients.

Type
Independent
Information
Journal of Law, Medicine & Ethics , Volume 32 , Issue 4 , Winter 2004 , pp. 759 - 764
Copyright
Copyright © American Society of Law, Medicine and Ethics 2004

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References

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Making Health Care Decisions (Washington, DC: US Government Printing Office, 1982); Kaplan, R.M., “Shared Medical Decision-Making: A New Paradigm for Behavioral Medicine -1997 Presidential Address,” Annals of Behavioral Medicine 21 (1997): 3–11; Forrow, L. Wartman, S.A., and Brock, D.W., “Science, Ethics, and the Making of Clinical Decisions: Implications for Risk Factor Intervention,” JAMA 259 (1988): 3161–67.Google Scholar
Charles, C. Gafni, A., and Whelan, T., “Shared Decision-making in the Medical Encounter: What Does It Mean? (or It Takes at Least Two to Tango),” Social Science & Medicine 44 (1997): 681–92.CrossRefGoogle Scholar
Kirsh, I., Jungeblut, A., and Jenkins, L., Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey (Washington, DC: United States Department of Education, 1993).Google Scholar
Williams, M.V., Baker, D.W., Honig, E.G., Lee, T.M., and Nowlan, A., “Inadequate Literacy is a Barrier to Asthma Knowledge and Self-care,” Chest 114 (1998): 1008–15.CrossRefGoogle Scholar
Baker, D.W., Gazmararian, J.A., Williams, M.V., et al., “Functional Health Literacy and the Risk of Hospital Admission Among Medicare Managed Care Enrollees,” American Journal of Public Health 92 (2002): 1278–83.CrossRefGoogle Scholar
Bennett, C.L., Ferreira, M.R., Davis, T.C., et al., “Relation Between Literacy, Race, and Stage of Presentation Among Low-income Patients with Prostate cancer,” Journal of Clinical Oncology 16 (1998): 3101–04.CrossRefGoogle Scholar
Kalichman, S.C., Ramachandran, B., and Catz, S., “Adherence to Combination Antiretroviral Therapies in HIV Patients of Low Health Literacy,” Journal of General Internal Medicine 14 (1999): 267–73.CrossRefGoogle Scholar
Schillinger, D., Grumbach, K., Piette, J. et al., “Association of Health Literacy with Diabetes Outcomes,” JAMA 288 (2000): 475–82.CrossRefGoogle Scholar
Weiss, B.D., Blanchard, J.S., McGee, D.L. et al., “Illiteracy Among Medicaid Recipients and its Relationship to Health Care Costs,” Journal of Health Care for the Poor and Underserved 5 (1994): 99–111.CrossRefGoogle Scholar
See Baker, , supra note 5 and Schillinger, , supra note 8.Google Scholar
See Baker, , supra note 5 and Weiss, , supra note 9.Google Scholar
Emanuel, E.J. and Emanuel, L.L., “Four Models of the Physician-patient Relationship,” JAMA 267 (1992): 2221–26; see Charles, , supra note 2.CrossRefGoogle Scholar
Charles, C. C., Gafni, A., and Whelan, T., “Decision-making in the Physician-patient Encounter: Revisiting the Shared Treatment Decision-making Model,” Social Science & Medicine 49 (1999): 651–61.CrossRefGoogle Scholar
Williams, M.V., Davis, T., Parker, R.M., and Weiss, B.D., “The Role of Health Literacy in Patient-physician Communication,” Family Medicine 34 (2000): 383–89.Google Scholar
Doak, C.C., Doak, L.G., Root, L.H., Teaching Patients with Low Literacy Skills (Philadelphia: J.B. Lippincott & Company, 1996); Schillinger, D., Piette, J., Grumbach, K., et al, “Closing the Loop: Physician Communication with Diabetic Patients who have Low Health Literacy,” Archives of Internal Medicine 163 (2003): 83–90; see Williams, , supra note 14.CrossRefGoogle Scholar
Maibach, E. and Parrott, R.L., Designing Health Messages: Approaches From Communication Theory and Public Health Practice (Thousand Oaks, CA: Sage Publications, 1995).Google Scholar
Kim, S.P. Knight, S.J. Tomori, C. et al., “Health Literacy and Shared Decision Making for Prostate Cancer Patients with Low Socioeconomic Status,” Cancer Investigation 19 (2001): 684–91; Meade, C.D., Calvo, A., and Cuthbertson, D., “Impact of Culturally, Linguistically, and Literacy Relevant Cancer Information Among Hispanic Farmworker Women,” Journal of Cancer Education 17 (2002): 50–54; Perdue, B.J. and Degazon, C., “You Make the Diagnosis: Case Study: Diagnoses and Interventions with Low Literacy,” Nursing Diagnosis 10 (1999): 36–39; Davis, T.C., Berkel, H.J., Arnold, C.L., Nandy, I., Jackson, R.H., and Murphy, P.W., “Intervention to Increase Mammography Utilization in a Public Hospital,” Journal of General Internal Medicine 13 (1998): 230–33.CrossRefGoogle Scholar
Weiss, B.D., Coyne, C., and Michielutte, R., “Communicating with Patients Who have Limited Literacy Skills: Consensus Statement from the National Work Group on Literacy and Health,” Journal of Family Practice 46 (1998): 168–76; Miles, S. and Davis, T., “Patients who Can't Read: Implications for the Health Care System,” JAMA 274 (1995): 1719–20; See Doak, , supra note 15.Google Scholar
Wolf, M.S., Davis, T.C., Cross, J.T., Marin, E., Green, K.M., and Bennett, C.L., “Health Literacy and Patient Knowledge in a Southern HIV Clinic,” International Journal of STD and AIDS 15 (2003):1144–50; Wolf, M.S., Hechinger, E., Davis, T.C., Arnold, C., Marin, E., and Bennett, C.L., “Health Literacy, Patient Knowledge, and Adherence to HAART,” San Diego, CA: Oral Presentation to the American College of Preventive Medicine Annual Meeting, 2003.Google Scholar
See Kim, , supra note 16.Google Scholar
See Doak, , supra note 15.Google Scholar
Davis, T.C., Williams, M.V., Marin, E., Parker, R.M., and Glass, J., “Health Literacy and Cancer Communication,” CA: A Cancer Journal for Clinicians 52 (2002): 134–49; see Wolf, , supra note 19.Google Scholar
Deber, R.B., Kraetschmer, N., Irvine, J., “What Role do Patients Wish to Play in Treatment Decision Making?” Archives of Internal Medicine 156 (1996): 1414–20; Ende, J., Kazis, L., Ash, A., and Moskowitz, M.A., “Measuring Patients' Desire for Autonomy: Decision Making and Information-seeking Preferences Among Medical Patients,” Journal of General Internal Medicine 4 (1989): 23–30; Robinson, A., and Thomson, R., “Variability in Patient Preferences for Participating in Medical Decision Making: Implication for the Use of Decision Support Tools,” Quality in Health Care 200110, Supp. 1 (2001): 34–38; Nease, R.F. Jr., and Brooks, W.B., “Patient Desire for Information and Decision Making in Health Care Decisions: The Autonomy Preference Index and the Health Opinion Survey,” Journal of General Internal Medicine 10 (1995): 593–600.CrossRefGoogle Scholar
See Charles, , supra note 13.Google Scholar
Guadagnoli, E. and Ward, P., “Patient Participation in Decision-making,” Social Science & Medicine 47 (1998): 329–39; Thompson, S.C. Pitts, J.S. and Schwankovsky, L., “Preferences for Involvement in Medical Decision-making: Situational and Demographic Influences,” Patient Education and Counseling 22 (1993): 133–40.CrossRefGoogle Scholar
Barry, C.A., Bradley, C.P., Britten, N., Stevenson, F.A., and Barber, N., “Patients' Unvoiced Agendas in General Practice Consultations: Qualitative Study,” BMJ 320 (2000): 1246–50.CrossRefGoogle Scholar
See Charles, , supra note 2, at 688.Google Scholar
Zachariae, R., Pedersen, C.G., Jensen, A.B., Ehrnrooth, E., Rossen, P.B., and von der Maase, H., “Association of Perceived Physician Communication Style with Patient Satisfaction, Distress, Cancer-related Self-efficacy, and Perceived Control Over the Disease,” British Journal of Cancer 88 (2003): 658–65; Kaplan, S.H., Greenfield, S., and Ware, J.E. Jr., “Assessing the Effects of Physician-patient Interactions on the Outcomes of Chronic Disease,” Medical Care 27 (1989): S110–27; Greenfield, S., Kaplan, S., Ware, J.E. Jr., “Expanding Patient Involvement in Care. Effects on patient outcomes,” Annals of Internal Medicine 102 (1985): 520–8.CrossRefGoogle Scholar
See Williams, , supra note 14.Google Scholar
Parker, R.M., Baker, D.W., Williams, M.V., and Nurss, J.R., “The Test of Functional Health Literacy in Adults: A New Instrument for Measuring Patients' Literacy Skills,” Journal of General Internal Medicine 10 (1995): 537–41; See Weiss, , supra note 18.CrossRefGoogle Scholar
de Ridder, D. and Schreurs, K., “Developing Interventions for Chronically Ill Patients: Is Coping a Helpful Concept?” Clinical Psychology Review 21 (2001): 205–40; Hilton, S., Sibbald, B., Anderson, H.R., and Freeling, P., “Controlled Evaluation of the Effects of Patient Education on Asthma Morbidity in General Practice,” Lancet 1 (1986): 26–29; Mellanby, A.R., Rees, J.B., and Tripp, J.H., “Peer-led and Adult-led School Health Education: A Critical Review of Available Comparative Research,” Health Education Research 15 (2000): 533–45; Morice, A.H. and Wrench, C., “The Role of the Asthma Nurse in Treatment Compliance and Self-management Following Hospital Admission,” Respiratory Medicine 95 (2001): 851–56; Nyamathi, A., Flaskerud, J.H., Leake, B., Dixon, E.L., and Lu, A., “Evaluating the Impact of Peer, Nurse Case-managed, and Standard HIV Risk-Reduction Programs on Psychosocial and Health-promoting Behavioral Outcomes Among Homeless Women,” Research in Nursing & Health 24 (2001): 410–22; Posavac, E.J., Kattapong, K.R., and Dew, D.E. Jr., “Peer-based Interventions to Influence Health-related Behaviors and Attitudes: A Meta-analysis,” Psychological Reports 85 (1999): 1179–947CrossRefGoogle Scholar