Overview

This research follows on directly from our previous HS&DR-funded project, which successfully met its objective to identify the key communication practices that neurologists are using to offer patients choice. In that previous research, we found that, overwhelmingly, when doctors listed options from which patients could make a decision about which course of action to follow, both clinicians and patients perceived that offering a choice had been enacted. On this basis, it would seem that our previous findings put us in a strong position for meeting a second main objective of the project: to provide effective practice guidelines to clinicians. In one sense this is the case. We are well-placed to provide guidance and training on how to offer choice; through the practice of option-listing. However, we are not, on the basis of this previous study, able to comment on how offering choice compares as an approach to initiating decision-making, with the alternative practice of recommending. Our previous analyses sensitized us to the ways in which being presented with a choice was sometimes resisted by patients, and in some instances led patients to actively seek a recommendation. 

This follow on project will undertake further research on our rich data set so that we will be in a better position to disseminate clear, systematic but flexible guidance on what ‘works’ best for patients and clinicians. Our findings should give doctors nuanced guidance on how best to engage patients in the decision-making process, in ways that are acceptable to patients themselves. Although our research will focus on neurology, we aim to produce guidelines of practical value to clinicians working in a range of settings. 

The project runs between August 2015 and April 2017 and is funded by the National Institute for Health Research.

People

Key Researchers involved in the project:

Prof. Markus Reuber (University of Sheffield)

Dr Merran Toerien (Sociology, University of York)

Dr Clare Jackson (Sociology, University of York)

Dr Paul Chappell (Sociology, University of York)

Findings

Generating the perception of choice: The remarkable malleability of option-listing

Published Version: Toerien, M., Reuber, M., Shaw, R. and Duncan, R. (2018). Generating the perception of choice: the remarkable malleability of option‐listing. Sociology of health & illness, 40(7), pp.1250-1267. 

Evaluating nuanced practices for initiating decision-making in neurology clinics: a mixed-methods study.

Published Version: Reuber, M., Chappell, P.J., Jackson, C. and Toerien, M.G. (2018). Evaluating nuanced practices for initiating decision-making in neurology clinics: a mixed-methods study. Health Services and Delivery Research.

Following the patient’s orders? Recommending vs. offering choice in neurology outpatient consultations

Published Version: Chappell, P., Toerien, M., Jackson, C. and Reuber, M. (2018). Following the patient's orders? recommending vs. offering choice in neurology outpatient consultations. Social Science & Medicine, 205, pp.8-16.