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

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Τίτλος: Shared Decision-Making and Patient Enablement in Outpatient Rehabilitation: An Observational Study.
Συγγραφείς: 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.
Πηγή: Physiotherapy research international : the journal for researchers and clinicians in physical therapy [Physiother Res Int] 2026 Oct; Vol. 31 (4), pp. e70326.
Τύπος έκδοσης: Journal Article; Observational Study; Multicenter Study
Γλώσσα: English
Στοιχεία περιοδικού: 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-
Ιατρικοί όροι (MeSH): 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
Περίληψη: 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.)
References: J Gen Intern Med. 2013 Jun;28(6):838-44. (PMID: 23307397)
J Educ Eval Health Prof. 2021;18:17. (PMID: 34325496)
PLoS One. 2011;6(10):e26255. (PMID: 22043310)
Mayo Clin Proc. 1996 Sep;71(9):829-37. (PMID: 8790257)
N Engl J Med. 2012 Mar 1;366(9):780-1. (PMID: 22375967)
Asian Bioeth Rev. 2022 Jan 17;14(2):133-150. (PMID: 35069883)
Patient Educ Couns. 2013 May;91(2):167-75. (PMID: 23318156)
Patient Educ Couns. 2022 Jul;105(7):2145-2150. (PMID: 35337712)
Patient Educ Couns. 2019 Apr;102(4):623-630. (PMID: 30578102)
Stroke. 1988 May;19(5):604-7. (PMID: 3363593)
Occas Pap R Coll Gen Pract. 1997 Feb;(75):i-xii, 1-32. (PMID: 9141884)
Fam Pract. 1998 Apr;15(2):165-71. (PMID: 9613486)
PLoS One. 2015 May 26;10(5):e0128063. (PMID: 26010755)
Health Policy. 2015 Mar;119(3):384-94. (PMID: 25467286)
Can J Nurs Res. 1997 Fall;29(3):21-43. (PMID: 9505581)
Patient Educ Couns. 2022 Jul;105(7):2546-2556. (PMID: 35184910)
Br J Gen Pract. 1999 Jun;49(443):477-82. (PMID: 10562751)
BMC Geriatr. 2021 Feb 6;21(1):112. (PMID: 33549059)
Patient Educ Couns. 2008 Nov;73(2):240-5. (PMID: 18752916)
Tohoku J Exp Med. 2012;227(2):97-104. (PMID: 22688526)
Patient Educ Couns. 2014 Mar;94(3):291-309. (PMID: 24305642)
Clin Rehabil. 2016 Dec;30(12):1200-1210. (PMID: 26647421)
BMC Musculoskelet Disord. 2014 Oct 04;15:333. (PMID: 25281209)
Br J Gen Pract. 2007 Dec;57(545):960-6. (PMID: 18252071)
BMC Med Inform Decis Mak. 2023 Jul 24;23(1):135. (PMID: 37488562)
J Prim Care Community Health. 2015 Oct;6(4):264-78. (PMID: 26229059)
Clin Rehabil. 2016 Sep;30(9):921-30. (PMID: 27496701)
Musculoskelet Sci Pract. 2018 Jun;35:84-89. (PMID: 29550697)
Am J Kidney Dis. 2022 Nov;80(5):599-609. (PMID: 35351579)
Cochrane Database Syst Rev. 2015 Mar 03;(3):CD010523. (PMID: 25733495)
BMC Health Serv Res. 2022 Sep 2;22(1):1116. (PMID: 36056354)
J Gen Intern Med. 2002 Apr;17(4):243-52. (PMID: 11972720)
Health Promot Int. 2008 Sep;23(3):269-74. (PMID: 18515303)
Mol Genet Metab Rep. 2022 Aug 10;32:100899. (PMID: 36046392)
Patient Educ Couns. 2024 Jul;124:108267. (PMID: 38547638)
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
Βάση Δεδομένων: MEDLINE
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  Data: Objectives: To examine the association between shared decision-making (SDM) and patient enablement in outpatient rehabilitation consultations.<br />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.<br />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.<br />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.<br /> (© 2026 The Author(s). Physiotherapy Research International published by John Wiley & Sons Ltd.)
– Name: Ref
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  Data: J Gen Intern Med. 2013 Jun;28(6):838-44. (PMID: <searchLink fieldCode="PM" term="%2223307397%22">23307397)</searchLink><br />J Educ Eval Health Prof. 2021;18:17. (PMID: <searchLink fieldCode="PM" term="%2234325496%22">34325496)</searchLink><br />PLoS One. 2011;6(10):e26255. (PMID: <searchLink fieldCode="PM" term="%2222043310%22">22043310)</searchLink><br />Mayo Clin Proc. 1996 Sep;71(9):829-37. (PMID: <searchLink fieldCode="PM" term="%228790257%22">8790257)</searchLink><br />N Engl J Med. 2012 Mar 1;366(9):780-1. (PMID: <searchLink fieldCode="PM" term="%2222375967%22">22375967)</searchLink><br />Asian Bioeth Rev. 2022 Jan 17;14(2):133-150. (PMID: <searchLink fieldCode="PM" term="%2235069883%22">35069883)</searchLink><br />Patient Educ Couns. 2013 May;91(2):167-75. (PMID: <searchLink fieldCode="PM" term="%2223318156%22">23318156)</searchLink><br />Patient Educ Couns. 2022 Jul;105(7):2145-2150. (PMID: <searchLink fieldCode="PM" term="%2235337712%22">35337712)</searchLink><br />Patient Educ Couns. 2019 Apr;102(4):623-630. (PMID: <searchLink fieldCode="PM" term="%2230578102%22">30578102)</searchLink><br />Stroke. 1988 May;19(5):604-7. (PMID: <searchLink fieldCode="PM" term="%223363593%22">3363593)</searchLink><br />Occas Pap R Coll Gen Pract. 1997 Feb;(75):i-xii, 1-32. (PMID: <searchLink fieldCode="PM" term="%229141884%22">9141884)</searchLink><br />Fam Pract. 1998 Apr;15(2):165-71. (PMID: <searchLink fieldCode="PM" term="%229613486%22">9613486)</searchLink><br />PLoS One. 2015 May 26;10(5):e0128063. (PMID: <searchLink fieldCode="PM" term="%2226010755%22">26010755)</searchLink><br />Health Policy. 2015 Mar;119(3):384-94. (PMID: <searchLink fieldCode="PM" term="%2225467286%22">25467286)</searchLink><br />Can J Nurs Res. 1997 Fall;29(3):21-43. (PMID: <searchLink fieldCode="PM" term="%229505581%22">9505581)</searchLink><br />Patient Educ Couns. 2022 Jul;105(7):2546-2556. (PMID: <searchLink fieldCode="PM" term="%2235184910%22">35184910)</searchLink><br />Br J Gen Pract. 1999 Jun;49(443):477-82. (PMID: <searchLink fieldCode="PM" term="%2210562751%22">10562751)</searchLink><br />BMC Geriatr. 2021 Feb 6;21(1):112. (PMID: <searchLink fieldCode="PM" term="%2233549059%22">33549059)</searchLink><br />Patient Educ Couns. 2008 Nov;73(2):240-5. (PMID: <searchLink fieldCode="PM" term="%2218752916%22">18752916)</searchLink><br />Tohoku J Exp Med. 2012;227(2):97-104. (PMID: <searchLink fieldCode="PM" term="%2222688526%22">22688526)</searchLink><br />Patient Educ Couns. 2014 Mar;94(3):291-309. (PMID: <searchLink fieldCode="PM" term="%2224305642%22">24305642)</searchLink><br />Clin Rehabil. 2016 Dec;30(12):1200-1210. (PMID: <searchLink fieldCode="PM" term="%2226647421%22">26647421)</searchLink><br />BMC Musculoskelet Disord. 2014 Oct 04;15:333. (PMID: <searchLink fieldCode="PM" term="%2225281209%22">25281209)</searchLink><br />Br J Gen Pract. 2007 Dec;57(545):960-6. (PMID: <searchLink fieldCode="PM" term="%2218252071%22">18252071)</searchLink><br />BMC Med Inform Decis Mak. 2023 Jul 24;23(1):135. (PMID: <searchLink fieldCode="PM" term="%2237488562%22">37488562)</searchLink><br />J Prim Care Community Health. 2015 Oct;6(4):264-78. (PMID: <searchLink fieldCode="PM" term="%2226229059%22">26229059)</searchLink><br />Clin Rehabil. 2016 Sep;30(9):921-30. (PMID: <searchLink fieldCode="PM" term="%2227496701%22">27496701)</searchLink><br />Musculoskelet Sci Pract. 2018 Jun;35:84-89. (PMID: <searchLink fieldCode="PM" term="%2229550697%22">29550697)</searchLink><br />Am J Kidney Dis. 2022 Nov;80(5):599-609. (PMID: <searchLink fieldCode="PM" term="%2235351579%22">35351579)</searchLink><br />Cochrane Database Syst Rev. 2015 Mar 03;(3):CD010523. (PMID: <searchLink fieldCode="PM" term="%2225733495%22">25733495)</searchLink><br />BMC Health Serv Res. 2022 Sep 2;22(1):1116. (PMID: <searchLink fieldCode="PM" term="%2236056354%22">36056354)</searchLink><br />J Gen Intern Med. 2002 Apr;17(4):243-52. (PMID: <searchLink fieldCode="PM" term="%2211972720%22">11972720)</searchLink><br />Health Promot Int. 2008 Sep;23(3):269-74. (PMID: <searchLink fieldCode="PM" term="%2218515303%22">18515303)</searchLink><br />Mol Genet Metab Rep. 2022 Aug 10;32:100899. (PMID: <searchLink fieldCode="PM" term="%2236046392%22">36046392)</searchLink><br />Patient Educ Couns. 2024 Jul;124:108267. (PMID: <searchLink fieldCode="PM" term="%2238547638%22">38547638)</searchLink>
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