Factors associated with level of shared decision making in Malaysian primary care consultations

Lee, Yew Kong and Chor, Yee Yang and Tan, Mae-Yen and Ngio, Yi Chen and Chew, Ai Wie and Tiew, Han Wei and Syahirah, Mohamed Reza and Ng, Chirk Jenn (2020) Factors associated with level of shared decision making in Malaysian primary care consultations. Patient Education and Counseling, 103 (5). pp. 1049-1051. ISSN 0738-3991,

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Abstract

Objective: To measure the level of shared decision-making (SDM) in primary care consultations in Malaysia, a multicultural, middle-income developing country. Methods: A cross-sectional study was conducted in an urban, public primary care clinic. Convenience sampling was used to recruit participants, and audio-recorded consultations were scored for SDM levels by two independent raters using the OPTION tool. Univariate and multivariate analysis was conducted to determine factors significantly associated with SDM levels. Results: 199 patients and 31 doctors participated. Mean consultation time was 14.3 min (+/- SD 5.75). Patients' age ranged from 18 to 87 years (median age of 57.5 years). 52.8 % of patients were female, with three main ethnicities (Malay, Chinese, Indian). The mean OPTION score was found to be 7.8 (+/- SD 3.31) out of 48. After a multivariate analysis, only patient ethnicity (beta= -0.142, p < 0.05) and increased consultation time (beta = 0.407, p < 0.01) were associated with higher OPTION scores. Conclusions: Patients in Malaysia experience extremely poor levels of SDM in general practice. Higher scores were associated with increased consultation time and patient ethnicity. Practice implications: Malaysian general practitioners should aim to develop and practice cultural competency skills to avoid biased SDM practice towards certain ethnicities. (C) 2019 Elsevier B.V. All rights reserved.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Shared decision making; Malaysia; Consultation; Primary care
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine
Faculty of Medicine > Primary Care Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 16 Feb 2024 01:13
Last Modified: 16 Feb 2024 01:13
URI: http://eprints.um.edu.my/id/eprint/36729

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