Shared Decision Making in Physical Therapy: a Cross-sectional Observational Study

March 5, 2018 updated by: Andrea Hausheer, cand. MScPT, Klinik Valens

Shared decision making (SDM) is increasingly recommended in health care and reduces the unbalanced power between physical therapists and patients. There is an increased focus on communication between physical therapists and their patients during the goal setting process in current research. This study will focus on SDM in physical therapy goal setting.

The SDM Process includes a problem definition and different goal options. Good communication between physical therapists and patients during the goal setting process with an explicit agreeing on both sides regarding treatment goals and options improves patient satisfaction, treatment adherence and health outcomes.

Patients generally prefer to be actively involved in the shared decision making process. However, the preferred level of involvement of patients regarding decisions differs. Therefore, physical therapist should consider about patients' preferred level of involvement in shared decision making. Previous research observed SDM behaviours of physical therapists only in private practice settings. Research in other settings like the rehabilitation setting are recommended. It is unknown whether there are differences between settings in the SDM behaviours of physical therapists during first consultation.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background

Shared decision making (SDM) is increasingly recommended in health care and reduces the unbalanced power between physical therapists and patients. There is an increased focus on communication between physical therapists and their patients during the goal setting process in current research. This study will focus on SDM in physical therapy goal setting.

The SDM Process includes a problem definition and different goal options. Therefore, SDM may be especially important during the goal setting process in the first consultation, where a problem definition and several goal options are of interest.

An increased involvement of patients in SDM is based on clear information, empathy, two-way communication and respect for patients' beliefs and concerns. Therefore, patients are more willing to reveal information. Good communication between physical therapists and patients during the goal setting process with an explicit agreeing on both sides regarding treatment goals and options improves patient satisfaction, treatment adherence and health outcomes.

During the shared goal setting several topics should be discussed including patient's expectations and concerns, different possible goals and their pros and cons. The quality of this communication during the goal setting process can be evaluated by the OPTION Scale.

Patients generally prefer to be actively involved in the shared decision making process.

Previous research observed SDM behaviours of physical therapists, the patient's preferred level of involvement and the agreement between the patient's preferred level of involvement and the physical therapists' perception of the patient's preference during different therapy consultations in private practice settings.

Communication between physical therapists and patients may be affected by patient's self-efficacy and educational background and physical therapist's education and working experiences. These factors will therefore be evaluated in the planned study. In addition, therapists should consider patients individual preferences regarding their preferred level of involvement in the goal setting process. The control preference scale measures patients' preferred level of involvement and physical therapists' perception of this level.

It is unknown whether there are differences between settings in the SDM behaviours of physical therapists. SDM may be different in rehabilitation and private practice settings. As in private practice one physical therapist is treating the patient, there are several physical therapists treating the patient in rehabilitation setting.

Study Type

Observational

Enrollment (Actual)

30

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Switzerland
      • Valens, Switzerland, 7317
        • Kliniken Valens

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Thirty patients will be recruited. The planned sample may seem heterogenic because patients with all musculoskeletal conditions are included. However, the goal setting process is expected to be independent of diagnosis and the sample is therefore considered sufficiently homogeneous.

Description

Inclusion Criteria:

musculoskeletal disorders First treatment German speaking

Exclusion Criteria:

n/a

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients & Physical therapists
First consultations of peoples with musculoskeletal disorders and their physical therapists will be audiotaped. Audiotapes will be used to analyse the communication between the patients and their physicaltherapists to explore how much physical therapists involve their patients in the goal setting process, to see if there is a shared decision making existing.
Behavioral: goal setting process
goal setting process during the first consultation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
OPTION scale
Time Frame: day 1 (e.g. "through study completion, an average of 1 year")
The OPTION scale measures physical therapists behaviour in shared decision making. It is a measurement that evaluates the involvement of patients in shared decision making and was shown to be reliable (Elwyn et al., 2003). The OPTION scale includes items looking at communication between physical therapist and patient, especially an identified problem, patient's beliefs and concerns, different goal and treatment option and their pros and cons, patient's preferred level of involvement, possibilities for patient's to ask questions and a review of the physical therapist at the end.
day 1 (e.g. "through study completion, an average of 1 year")

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Control Preference Scale (CPS)
Time Frame: day 1 (e.g. "through study completion, an average of 1 year")
The Control Preference Scale (CPS) measures physical therapists perception about their patient's preferences and patient's preference in SDM. The CPS is valid and reliable in healthcare decision making, easy to conduct and clinically relevant (Degner et al., 1997).
day 1 (e.g. "through study completion, an average of 1 year")

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
General Self-Efficacy Scale (GSE)
Time Frame: day 1 (e.g. "through study completion, an average of 1 year")
The General Self-Efficacy Scale (GSE) measures self-reported self-efficacy. The GSE is valid and Cronbach's alpha of internal reliability is between .76 and .90. Positive correlations to emotion, optimism, work satisfaction and negative correlations to depression, stress, health complaints, burnout and anxiety are examined. (Luszczynska et al., 2005) The GSE is potentially associated with SDM preference.
day 1 (e.g. "through study completion, an average of 1 year")
Characteristics of patients and physical therapists
Time Frame: day 1 (e.g. "through study completion, an average of 1 year")

The following characteristics will be assessed because of their possible influence on SDM preferences.

Patients: age, sex, previous therapy for current problem, profession Physiotherapists: age, sex, work experiences in years, education
day 1 (e.g. "through study completion, an average of 1 year")

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Klinik Valens

Investigators

  • Principal Investigator: Andrea C. Hausheer, cand. MScPT, Klinik Valens

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 1, 2017

Primary Completion (ACTUAL)

January 31, 2018

Study Completion (ACTUAL)

March 5, 2018

Study Registration Dates

First Submitted

August 5, 2017

First Submitted That Met QC Criteria

August 29, 2017

First Posted (ACTUAL)

August 30, 2017

Study Record Updates

Last Update Posted (ACTUAL)

March 6, 2018

Last Update Submitted That Met QC Criteria

March 5, 2018

Last Verified

March 1, 2018

More Information

Terms related to this study

Other Study ID Numbers

  • Projekt ID: 2017-00848

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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