{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:32:05Z","timestamp":1787563925389,"version":"build-2736575974"},"reference-count":52,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020363","name":"Institute for Information Industry, Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107-2314-B-038 -026 -MY3"],"award-info":[{"award-number":["MOST 107-2314-B-038 -026 -MY3"]}],"id":[{"id":"10.13039\/501100020363","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020363","name":"Institute for Information Industry, Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 110-2628-H-006 -006 -MY3"],"award-info":[{"award-number":["MOST 110-2628-H-006 -006 -MY3"]}],"id":[{"id":"10.13039\/501100020363","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University System of Taipei Joint Research Program","award":["USTP-NTPU-TMU-110-01"],"award-info":[{"award-number":["USTP-NTPU-TMU-110-01"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,23]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Various treatment options are available for degenerative joint disease (DJD). During clinical visits, patients and clinicians collaboratively make decisions regarding the optimal treatment for DJD; this is the essence of shared decision-making (SDM). Here, we collated and assessed the SDM-related experiences and perspectives of outpatients with DJD in Taiwan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In-depth interviews and thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care clinics of a regional teaching hospital in Taiwan, October 2021\u2013May 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>21 outpatients with at least three visits for DJD and who were aware of SDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four main themes emerged in this study: first, equipping themselves with knowledge: outpatients obtained disease-related and treatment-related knowledge in various ways\u2014seeking relevant information online, discussing with family and friends, learning from their own experiences or learning from professionals. Second, shared or not shared: physicians had different patterns for communicating with patients, particularly when demonstrating authority, performing mutual discussion, respecting patient preferences or responding perfunctorily. Third, seldom saying no to physician-prescribed treatment plans during clinical visits: most patients respected physicians\u2019 professionalism; however, some patients rejected physicians\u2019 recommendations indirectly, whereas some responded depending on their disease prognosis. Fourth, whose call?\u2014participants decided to accept or reject a treatment plan independently or by discussing it with their families or by obeying their physicians\u2019 recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In general, patients with DJD sought reliable medical information from various sources before visiting doctors; however, when having a conversation with patients, physicians dominated the discussion on treatment options. The patient\u2013physician interaction dynamics during the SDM process determined the final medical decision, which was in accordance with either patients\u2019 original autonomy or physicians\u2019 recommendations. To alleviate medical paternalism and physician dominance, patients should be empowered to engage in medical decision-making and share their opinions or concerns with their physicians. Family members should also be included in SDM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075693","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T01:26:32Z","timestamp":1706923592000},"page":"e075693","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Experiences and perspectives related to shared decision-making among outpatients with degenerative joint disease in Taiwan: a qualitative study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2559-7184","authenticated-orcid":false,"given":"Yeu-Hui","family":"Chuang","sequence":"first","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Nursing, Wan Fang Hospital, Taipei, Taiwan"},{"name":"Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei, 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