Determinants of Shared Decision-making and Its Relationship with Home-based Exercise Adherence in Stroke Survivors: A Cross-sectional Study
Jignasha N. Gohil, Vishakha Singh, Sejal Parmar, Shivani Bhagwakar, Lokendra SinghAbstract
Context:
Shared decision-making (SDM) is recognized as a key component of patient-centred rehabilitation and aims to involve patients in clinical decision-making processes regarding their treatment. In stroke rehabilitation, SDM may enhance patient engagement and promote active participation in recovery; however, evidence regarding its relationship with adherence to home-based exercise programmes remains limited.
Aims:
The present study aimed to examine the level of SDM, identify its sociodemographic predictors, and investigate the relationship between SDM and adherence to home-based exercise programs among stroke survivors.
Settings and Design:
A cross-sectional study was conducted among 92 stroke survivors receiving outpatient physiotherapy rehabilitation across South Gujarat with convenient sampling technique.
Subjects and Methods:
SDM was assessed using the Observing Patient Involvement (OPTION) Scale, while adherence to home-based exercise programs was evaluated using Exercise Adherence Rating Scale.
Statistical Analysis Used:
Descriptive statistics, a multiple linear regression analysis and Spearman correlation were performed.
Results:
The findings demonstrated a moderate level of SDM, with a mean OPTION score of 32.84 ± 8.65, indicating partial implementation of collaborative decision-making behaviors during rehabilitation consultations. Education emerged as the only significant sociodemographic predictor of SDM. The correlation analysis revealed no significant association between SDM and home-based exercise adherence (ρ =0.032,
Conclusions:
The results suggest that SDM is moderately implemented in outpatient stroke rehabilitation and may be influenced by patients’ educational status. However, SDM alone may not be sufficient to improve adherence to home-based exercise programs.