Shared decision making in clinical settings: Developing participatory processes to assist patients and surgeons in the medical encounter

In a world where access to clinical evidenced based information is easier everyday, shared decision making is increasingly being a topic of discussion. It is understood as a sharing of information between parts to reach an option agreement. Typically, physicians share knowledge and patients expose their thoughts and concerns. There are some actions that would need for the involvement of a community to be effective. This work introduces a new concept: community-­shared decision making. Although it is under the frame of SDM it is an unexplored topic. The medical decision presented is the Human Papillomavirus vaccination in men, the objective of the thesis is to assist the community of patients to communicate among themselves regarding this topic. When facing a decision where different aspects matter, a multicriteria decision analysis method is required. This method follows a socio-­technical approach. The social component aims to capture the points of views of participants, the technical one builds a model to help elicit a decision taking into account all the criteria that matters and at which level. Male university students were invited to an online 2 round Delphi process. They were presented with the highlights of HPV and vaccine’s implications and, later, asked to assess importance of them. The community SDM was given at this point, while presented with the views of the colleagues and having to assess importance again. The results showed a remarkably low awareness of HPV. The community also presented a high concern for being protected against the infection. For the other implications, a high dispersion of results was obtained, therefore, the medical society could not be informed about male’s community decision regarding the vaccine. Future work needs to be done and the medical community needs to raise awareness regarding HP