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Collaborative deliberation: a model for patient care

Elwyn, Glyn, Lloyd, Amy ORCID:, May, Carl, van der Weijden, Trudy, Stiggelbout, Anne, Edwards, Adrian ORCID:, Frosch, Dominick L., Rapley, Tim, Barr, Paul, Walsh, Thom, Grande, Stuart W., Montori, Victor and Epstein, Ronald 2014. Collaborative deliberation: a model for patient care. Patient Education and Counseling 97 (2) , pp. 158-164. 10.1016/j.pec.2014.07.027

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Objective: Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. Methods: Theory building among researchers with experience and expertise in clinician–patient communication, using an iterative cycle of discussions. Results: We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model ‘collaborative deliberation.’ The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. Conclusions: We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Publisher: Elsevier
ISSN: 0738-3991
Date of Acceptance: 5 July 2014
Last Modified: 28 Oct 2022 10:37

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