| Objective: To identify determinants of shared decision making in patients with
multiple myeloma (MM) to facilitate the design of a program to maximize the effects
of shared decision making.
Methods: This prospective longitudinal study recruited 276 adult patients (52%
male, mean age 62.86 y, SD 15.45). Each patient completed the eHealth Literacy
Scale (eHEALS), Multidimensional Trust in Health Care Systems Scale (MTHCSS),
Patient Communication Pattern Scale (PCPS), and 9‐Item Shared Decision‐Making
Questionnaire (SDM‐Q‐9) at baseline and the SDM‐Q‐9 again 6 months later. One
family member of the patient completed the Family Decision‐Making Self‐Efficacy
(FDMSE) at baseline. Structural equation modeling (SEM) was used to investigate
the associations between eHealth literacy (eHEALS), trust in the health care system
(MTHCSS), self‐efficacy in family decision making (FDMSE), patient communication
pattern (PCPS), and shared decision making (SDM‐Q‐9).
Results: SEM showed satisfactory fit (comparative fit index = 0.988) and significant
correlations between the following: eHealth literacy and trust in the health care
system (β = 0.723, P < 0.001); eHealth literacy and patient communication pattern
(β = 0.242, P < 0.001); trust in the health care system and patient communication
pattern (β = 0.397, P < 0.001); self‐efficacy in family decision making and patient
communication pattern (β = 0.264, P < 0.001); eHealth literacy and shared decision
making (β = 0.267, P < 0.001); and patient communication pattern and shared
decision making (β = 0.349, P < 0.001).
Conclusions: Patient communication and eHealth literacy were found to be
important determinants of shared decision making. These factors should be taken
into consideration when developing strategies to enhance the level of shared decision
making. |