Persuasive communication in medical decision-making during consultations with patients with limited health literacy in hospital-based palliative care |
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| Institution: | 1. NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands;2. Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands;3. Department of Social Medicine, Maastricht University, Maastricht, The Netherlands;4. Pharos, Dutch Centre of Expertise on Health Disparities, Utrecht, The Netherlands;5. Department of Primary and Community Care, Radboud University, Nijmegen, The Netherlands;1. Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway;2. Centre of Medical Ethics, University of Oslo, Oslo, Norway;1. Department of Family Medicine, Division of community health, Faculty of health sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;2. Department of Counseling and Human Development, Haifa University, Israel;1. Indiana University School of Medicine, 473 Barnhill Drive, Indianapolis, IN 46202, USA;2. Indiana University Simon Cancer Center, 473 Barnhill Drive, Indianapolis, IN 46202, USA;3. Regenstrief Institute, 473 Barnhill Drive, Indianapolis, IN 46202, USA;4. Indiana University Purdue University at Indianapolis (IUPUI), 473 Barnhill Drive, Indianapolis, IN 46202, USA;5. Indiana University Health, 473 Barnhill Drive, Indianapolis, IN 46202, USA;6. Indiana University Medical Library, 473 Barnhill Drive, Indianapolis, IN 46202, USA;1. Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA;2. Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA;3. Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA;4. YMCA of Greater Richmond, Richmond, VA, USA |
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| Abstract: | ObjectiveBoth patients in the palliative phase of their disease and patients with limited health literacy (LHL) have an increased risk of being influenced by healthcare providers (HCPs) when making decisions. This study aims to explore to what extent persuasive communication occurs during shared decision-making (SDM) by (1) providing an overview of persuasive communication behaviours relevant for medical decision-making and (2) exemplifying these using real-life outpatient consultations.MethodsAn exploratory qualitative design was applied: (1) brief literature review; (2) analysis of verbatim extracts from outpatient consultations and stimulated recall sessions with HCPs; and (3) stakeholder meetings.Results24 different persuasive communication behaviours were identified, which can be divided in seven categories: biased presentation of information, authoritative framing, probability framing, illusion of decisional control, normative framing, making assumptions and using emotions or feelings.ConclusionsPersuasive communication is multi-faceted in outpatient consultations. Although undesirable, it may prove useful in specific situations making it necessary to study the phenomenon more in depth and deepen our understanding of its mechanisms and impact.Practice implicationsAwareness among HCPs about the use of persuasive communication needs to be created through training and education. Also, HCPs need help in providing balanced information. |
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| Keywords: | Cancer Communication COPD Healthcare providers Limited health literacy Oncology Palliative care Patients Persuasion Shared decision-making Qualitative research |
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