Assessing patients’ participation and quality of decision-making: insights from a study of routine practice in diverse settings

Vikki A. Entwistle, Ian S. Watt, Ken Gilhooly, Carol Bugge, Neva Haites, Anne E. Walker

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    51 Citations (Scopus)


    In the context of a qualitative study exploring patients’ participation in decision-making, we investigated how people interpret and respond to structured questions about decision-making about their health care. Seventy-four participants who attended consultations in five clinical areas completed structured measures of decision-making and discussed their responses during interviews. They identified a range of decisions as having being made in their consultations. People who picked particular responses on measures of participation in and satisfaction with decision-making gave varied explanations for these, not all of which were consistent with the way their responses are usually interpreted. The interview data suggest that people’s evaluations of decisions to follow a particular course of action were influenced by various factors including what they focused on as the alternative, their perceptions of constraints on choices, and their assessment of how good the best possible solution was. Responses to simple structured measures of participation in and satisfaction with decisionmaking should be interpreted with caution. They are not reliably attributable to health care providers’ actions and are thus unsuitable for performance assessment purposes.
    Original languageEnglish
    Pages (from-to)105-113
    Number of pages9
    JournalPatient Education and Counseling
    Issue number1
    Publication statusPublished - Oct 2004



    • Decision quality
    • Shared decision-making
    • Performance assessment

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