Collaborative deliberation: A model for patient care

Glyn Elwyn*, Amy Lloyd, Carl May, Trudy van der Weijden, Anne Stiggelbout, Adrian Edwards, Dominick L. Frosch, Tim Rapley, Paul Barr, Thom Walsh, Stuart W. Grande, Victor Montori, Ronald Epstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

128 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)158-164
Number of pages7
JournalPatient Education and Counseling
Volume97
Issue number2
Early online date13 Aug 2014
DOIs
Publication statusPublished - Nov 2014

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