{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T14:52:11Z","timestamp":1768402331256,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T00:00:00Z","timestamp":1521936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"British Tinnitus Association"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2018,9]]},"abstract":"\n Objectives<\/jats:title>\n This study examined clinical encounters between clinicians and patients to determine current practice for the diagnosis and treatment of tinnitus. The objective was to develop an understanding of the ideal clinical encounter that would facilitate genuine shared decision\u2010making.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Video ethnography was used to examine clinical encounters for the diagnosis and treatment of tinnitus.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Clinical encounters were video\u2010recorded. Patients were interviewed individually following their clinic appointment. Data were analysed using constant comparison techniques from Grounded Theory. Initial inductive analyses were then considered against theoretical conceptualizations of the clinician\u2013patient relationship and of the clinical encounter.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Alignment between clinician and patient was found to be essential to a collaborative consultation and to shared decision\u2010making. Clinician groups demonstrated variation in behaviour in the encounter; some asked closed questions and directed the majority of the consultation; others asked open questions and allowed patients to lead the consultation.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A shift away from aetiology and physiological tests is needed so that tinnitus is managed as a persistent unexplained set of symptoms. This uncertainty is challenging for the medical professionals; lessons could be learned from the use of therapeutic skills. Further research is required to test techniques, such as the use of decision aids, to determine how we might create the ideal clinical encounter.<\/jats:p>\n <\/jats:sec>\n \n \n \n \n \n Statement of contribution<\/jats:title>\n <\/jats:caption>\n \n \n What is already known on this subject?<\/jats:bold>\n <\/jats:italic>\n \n \n Tinnitus is a condition in which sound is heard in the absence of an external source. Current approaches to managing tinnitus vary depending on clinical site (Hoare & Hall, 2011).<\/jats:p>\n <\/jats:list-item>\n \n In most instances, tinnitus does not have a straightforward medical cause. Tinnitus care is challenging to traditional biomedical encounters because the process of diagnosis may not lead to a defined treatment.<\/jats:p>\n <\/jats:list-item>\n \n Clinicians are required to consider not only what the tinnitus sounds like but more importantly, what it means for the affected individual. This requires a careful and skilled approach to eliciting a patient's current behaviour, coping, and preferences for both outcomes and treatment approaches.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n \n \n What does this study add?<\/jats:bold>\n <\/jats:italic>\n <\/jats:p>\n \n \n \n We provide the first in\u2010depth description of decision\u2010making in clinical services for tinnitus.<\/jats:p>\n <\/jats:list-item>\n \n Findings suggest a shift in focus is required to move away from the current prioritization of the biomedical treatment of tinnitus.<\/jats:p>\n <\/jats:list-item>\n \n There is variation to the extent different clinicians were able to deal with the uncertainty presented by the symptoms of tinnitus.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bjhp.12308","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T05:49:34Z","timestamp":1521956974000},"page":"630-645","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Shared decision\u2010making in tinnitus care \u2013 An exploration of clinical encounters"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5183-6236","authenticated-orcid":false,"given":"Helen","family":"Pryce","sequence":"first","affiliation":[{"name":"School of Life & Health Sciences Aston University Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Hall","sequence":"additional","affiliation":[{"name":"School of Life & Health Sciences Aston University Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Marks","sequence":"additional","affiliation":[{"name":"Psychology Department University of Bath UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth\u2010Anne","family":"Culhane","sequence":"additional","affiliation":[{"name":"Audiology Department St Georges Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Swift","sequence":"additional","affiliation":[{"name":"Hearing Therapy and Audiology Department UHBristol NHS Trust UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Straus","sequence":"additional","affiliation":[{"name":"NIHR NWL CLAHRC Improvement [Patient] Fellow London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel L.","family":"Shaw","sequence":"additional","affiliation":[{"name":"School of Life & Health Sciences Aston University Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2006.05.028"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7419.864"},{"key":"e_1_2_7_4_1","first-page":"477","article-title":"Shared decision\u2010making in primary care: The neglected second half of the consultation","volume":"49","author":"Elwyn G.","year":"1999","journal-title":"British Journal of General Practice"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2077-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000100"},{"key":"e_1_2_7_7_1","volume-title":"The theory of communicative action","author":"Habermas J.","year":"1986"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781405165518.wbeose070"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0163278710390355"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.9.3.222"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.08.015"},{"key":"e_1_2_7_12_1","volume-title":"Patients\u2019 preferences matter: Stop the silent misdiagnosis","author":"Mulley A.","year":"2012"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpmed.2016.09.012"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","unstructured":"Pryce H. Hall A. Shaw R. L. Culhane B.\u2010A. Swift S. Straus J. &Claesen B.(2017).Patient preferences in tinnitus treatments and outcomes: A qualitative study. 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