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Shared Decision-Making and Patient Enablement in Outpatient Rehabilitation: An Observational Study.

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Title: Shared Decision-Making and Patient Enablement in Outpatient Rehabilitation: An Observational Study.
Authors: Iwasawa N; Teikyo University Graduate School of Public Health, Tokyo, Japan.; TOYOTA TSUSHO All Life Corporation, AViC THE PHYSIO STUDIO, Tokyo, Japan., Hori S; TOYOTA TSUSHO All Life Corporation, AViC THE PHYSIO STUDIO, Tokyo, Japan., Fujita H; TOYOTA TSUSHO All Life Corporation, AViC THE PHYSIO STUDIO, Tokyo, Japan., Yamada T; Teikyo University Graduate School of Public Health, Tokyo, Japan., Ishikawa H; Teikyo University Graduate School of Public Health, Tokyo, Japan.
Source: Physiotherapy research international : the journal for researchers and clinicians in physical therapy [Physiother Res Int] 2026 Oct; Vol. 31 (4), pp. e70326.
Publication Type: Journal Article; Observational Study; Multicenter Study
Language: English
Journal Info: Publisher: John Wiley & Sons Country of Publication: United States NLM ID: 9612022 Publication Model: Print Cited Medium: Internet ISSN: 1471-2865 (Electronic) Linking ISSN: 13582267 NLM ISO Abbreviation: Physiother Res Int Subsets: MEDLINE
Imprint Name(s): Publication: 2006- : Hoboken, NJ : John Wiley & Sons
Original Publication: London ; Lawrence, KS : Whurr Publishers, c1996-
MeSH Terms: Decision Making, Shared* , Patient Participation* , Ambulatory Care* , Outpatients*, Humans ; Female ; Male ; Cross-Sectional Studies ; Aged ; Japan ; Middle Aged ; Surveys and Questionnaires ; Severity of Illness Index ; Decision Making
Abstract: Objectives: To examine the association between shared decision-making (SDM) and patient enablement in outpatient rehabilitation consultations.
Methods: In this observational cross-sectional study, 158 patients attending outpatient rehabilitation at four facilities in Japan were assessed, of whom 93 were included in the final analyses. Sociodemographic data, disease severity (modified Rankin Scale), treatment expectations, control preferences, and health literacy were collected via self-administered questionnaires. SDM was assessed using the SDM for Rehabilitation (SDM-Reha) scale, and patient enablement was assessed using the Patient Enablement Instrument (PEI). Linear mixed-effects models were used to examine the association between SDM-Reha and PEI, adjusting for age, sex, and disease severity (modified Rankin Scale [mRS]), with therapist ID included as a random effect to account for clustering.
Results: The mean age was 68.3 years (SD = 12.5), and 50.5% were male. The mean SDM-Reha and PEI scores were 48.7 (SD = 7.0) and 5.3 (SD = 3.1), respectively. In the linear mixed-effects model adjusting for age, sex, and disease severity (modified Rankin Scale, mRS), SDM-Reha was significantly associated with PEI scores (β = 0.13, 95% CI 0.03-0.21, p = 0.012). Age, sex, and disease severity were not significantly associated with PEI.
Conclusion: Higher perceived SDM was associated with greater patient enablement in Japanese outpatient rehabilitation consultations. These findings suggest a potential relationship between rehabilitation decision-making experiences and patients' perceived ability to understand and manage their condition, but causal inferences are limited by the cross-sectional design.
(© 2026 The Author(s). Physiotherapy Research International published by John Wiley & Sons Ltd.)
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Grant Information: 25K02857 JSPS KAKENHI
Contributed Indexing: Keywords: outpatient rehabilitation; patient enablement; patient preferences; patient‐centered rehabilitation; rehabilitation goal setting; shared decision‐making
Entry Date(s): Date Created: 20260827 Date Completed: 20260827 Latest Revision: 20260910
Update Code: 20260911
PubMed Central ID: PMC13519965
DOI: 10.1002/pri.70326
PMID: 42657607
Database: MEDLINE
Description
ISSN:1471-2865
DOI:10.1002/pri.70326