Integrative Review of the Components of Shared Decision-Making

Abstract

Shared decision-making in medicine (SDM), which involves collaboration between patients and physicians, is one of the leading medical decision-making methods. This study aims to identify the components of SDM in end-of-life care by conducting an integrative literature review on SDM research. The study adopted Whittemore and Knafl’s integrative review methodology and analyzed 13 domestic and foreign articles. Based on this review, the following five components of SDM were identified. First, patients and physicians form partnerships in which both play an active role in the decision-making process. Second, information is exchanged between patients and physicians in a circular and transparent manner. Third, sufficient time is spent on meetings, deliberation, and decision-making. Fourth, the decisions that are made are mutually satisfactory and understood by both participants. Fifth, attempts are made to determine whether the patient’s intentions have changed even after a shared-decision is made. In addition to identifying the components of SDM in end-of-life care, this article argues that it is necessary to change certain perceptions and attitudes of medical personnel to enhance patient participation and the exchange of information with patients.