Work

How option-listing influences decision-making in orthopedic consultations: a conversation analytic study

Year: 2024

Type: article

Abstract: Examine which practices orthopedists use to do option-listing, a technique that can facilitate shared decision-making (SDM). A conversation analytic study of 35 orthopedic consultations with newly referred patients with hip and/or knee osteoarthritis. Orthopedists implement option-listing in consultations using two organizational principles: 1) A fixed order of options that constitutes a scale (based on the severity of treatment). Presenting this scale (in two possible orders) encodes this fixed order; 2) Options are presented in relation to each other, rather than as individual options to be discussed incrementally. This format provides orthopedists with interactional slots to formulate their professional stance by presenting options as considered but rejected. Patients co-construct this list by taking a recipient role and not responding to the individual items of the list. Option-listing can facilitate SDM, allowing patients to choose amongst options. A drawback is that, while the organizational principles of option-listing allow orthopedists to express a professional opinion, they also place patients in an interactional position in which they have to address the orthopedists’ epistemic stance. On the other hand, patients can use the scale to propose their own preferences. Awareness of the interactional consequences of option-listing might optimize SDM. • Orthopedists use option-listing in consultations about hip or knee osteoarthritis. • Options are presented in a fixed order (constituting a scale) and in a list format. • Option-listing facilitates SDM, allowing patients to choose between options. • However, the practices used to do option-listing also have drawbacks. • Awareness of the interactional consequences of option-listing might optimize SDM.

Source: Patient Education and Counseling

DOI: 10.1016/j.pec.2024.108450

Authors: A.C. (Anouk) Van der Hout, Mike Huiskes, Taco Gosens, Brenda L. Den Oudsten

Institutions: Tilburg University, University of Groningen, Elisabeth-TweeSteden Ziekenhuis

Language: English

Topic: Patient-Provider Communication in Healthcare

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,350