Evaluating practices for initiating decision making in neurology
Research type
Research Study
Full title
Evaluating nuanced practices for initiating decision making in neurology clinics
IRAS ID
172363
Contact name
Markus Reuber
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 8 months, 30 days
Research summary
This project builds on our previous examination of conversations during neurology appointments conducted to explore how and how often doctors offer patients choices. To do this, we video/audio recorded 223 appointments and asked doctors and patients about their experience of these. We found out how often choice was offered and which communication methods were best understood by patients as offering them choice. We found that choice per se was not associated with greater patient statisfaction. However, our analysis suggested that choice might be valued much more by patients in some situations than in others. There are clearly some situations when patients do not want to make a choice or doctors believe there is only one reasonable option. We therefore want to do some more work on the same set of recordings and questionnaires we collected for the original study. This should allow us to advise doctors on whether – and if so, when – it is better to give choice or to make a recommendation. This matters because the NHS is strongly in favour of increasing patient choice. Yet there is little guidance on how doctors might do this in practice or about when there might be good reason to avoid choice in favour of recommending. We have been granted follow-on funding by the National Institute for Health Research to do this additional work. The study will use a mix of conversation-analysis inspired coding of interactional phenomena, patient-reported satisfaction data and statistical analyses. It will be carried out by a team of two social scientists, a neurologist and a research fellow. It will be guided by: i) an expert in statistics; ii) a Steering Group, made up of patients and experts in communication and neurology; and iii) a Service Users Group, made up of patients and others who use neurological services.
REC name
North West - Greater Manchester South Research Ethics Committee
REC reference
15/NW/0625
Date of REC Opinion
23 Jul 2015
REC opinion
Favourable Opinion