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Barriers to Shared Decision-Making in Ophthalmologic Care - Coggle Diagram
Barriers to Shared Decision-Making in Ophthalmologic Care
Patient Factors
Understanding of treatment options
Health literacy
Financial constraints
Fear/anxiety about procedures
Trust in provider
Cultural beliefs / values
Provider Factors
Communication style
Framing of options (bias)
Time constraints
Clinical uncertainty
Experience level
Comfort with shared decision-making
System Factors
Public vs private care (OHIP vs paid)
Access to services
Cost differences (PRK vs PTK, CXL variations)
Clinic workflow pressures
Revenue targets / business model
Availability of technology
Ethical Considerations
Patient autonomy
Informed consent vs true understanding
Equity in access
Transparency of options
Conflict of Interest
Cognitive & Decision-Making Complexity
Ill-defined problems (Cristancho et al.)
Non-linear decision-making
Bias (provider + patient)
Uncertainty in outcomes
Barriers to SDM
Limited consultation time
Inconsistent communication
Perceived superiority of private treatments
Lack of standardized education
Patients feeling overwhelmed
Potential Strategies / Improvements
Decision aids (Elwyn model)
Staff training in communication
Clear comparison of all options
Structured consultation process
Outcomes/ Impact
Patient satisfaction
Quality of decisions
Trust in healthcare system
Treatment adherence
Health equity