Patient's Perspective of Shared Decision-Making in Rheumatoid Arthritis Treatment: A Grounded Theory Exploration

Authors

Isabela Viana Oliveira, Universidade Federal de Minas GeraisFollow
Mariana Martins Gonzaga Nascimento, Universidade Federal de Minas GeraisFollow
Cristiane P. Rezende Mrs, Federal University of Minas GeraisFollow
Carina M. Neves, Universidade Federal de Minas GeraisFollow
Hagabo Mathyell Silva, Universidade Federal de Minas GeraisFollow
Ana Luiza Mourawad Cesar, Universidade Federal de Minas GeraisFollow
Djenane Ramalho de Oliveira, Universidade Federal de Minas GeraisFollow

Abstract

Current guidelines for rheumatoid arthritis (RA) treatment state that all decisions should be shared with the patient. Therefore, it becomes necessary to understand in-depth how patients with RA with different levels of health literacy and activation feel about sharing the decision with the health professional and how they experience this process. Grounded theory was used. Data collection included semi-structured interviews with 14 patients with RA. From the analysis of the patients’ narratives, four categories were built: “Accepting the changes: non-shared decisions”; “The patient's rationale: why not share?”; “Reaching the requirements for sharing the decision: expanding the patient’s autonomy"; and "Experiencing the sharing of the decision: ‘there is no point in changing, if I do not use it’." The results revealed that patients do not feel involved nor prepared to make decisions regarding their pharmacotherapy, even though they often engage in decision-making on their own. Some feel invisible as they are not included in the process. Those who feel unprepared for sharing the decision recognize that they could achieve it by acquiring the necessary knowledge. The theoretical model developed explains that shared decision-making is a way to consider the patient's experiences with the use of medicines and prevent them from making helpless decisions.

Keywords

grounded theory, health literacy, patient activation, rheumatoid arthritis, shared decision-making

Author Bio(s)

Isabela Viana Oliveira is a doctorate student at Federal University of Minas Gerais. Please direct correspondence to isabelaviana.far@gmail.com.

Mariana Martins Gonzaga do Nascimento is an Adjunct Faculty at Federal University of Minas Gerais. Please direct correspondence to marianamgn@yahoo.com.br.

Cristiane de Paula Rezende is a doctorate student at Federal University of Minas Gerais. Please direct correspondence to cris7paula@gmail.com.

Carina de Morais Neves is a master’s student at Federal University of Minas Gerais. Please direct correspondence to carinamneves@gmail.com.

Hágabo Mathyell Silva is a master’s student at Federal University of Minas Gerais. Please direct correspondence to hagaboms@gmail.com.

Ana Luiza Mourawad César is a pharmacy student at Federal University of Minas Gerais. Please direct correspondence to analuizamourawad1406@gmail.com.

Djenane Ramalho-de-Oliveira is an associate professor and Director of the Center for Pharmaceutical Care Studies at Federal University of Minas Gerais. Please direct correspondence to djenane.oliveira@gmail.com.

Acknowledgements

We thank all patients who were participants in this study.

Publication Date

7-5-2023

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.

DOI

10.46743/2160-3715/2023.6196

Recommended APA Citation

Oliveira, I. V., Nascimento, M. M., Rezende, C. P., Neves, C. M., Silva, H. M., Cesar, A. M., & Ramalho de Oliveira, D. (2023). Patient's Perspective of Shared Decision-Making in Rheumatoid Arthritis Treatment: A Grounded Theory Exploration. The Qualitative Report, 28(7), 1902-1926. https://doi.org/10.46743/2160-3715/2023.6196

ORCID ID

0000-0002-5548-8184