Introduction
Adult strabismus is a very complex, multi-dimensional disease which has a serious impact on sightseeing, self-perception, self-esteem and the social interactions of the patient1. Important treatment options, including optical correction, prism prescription, correction, various surgical approaches and botox injections all of them are significant, each with the individual advantages and disadvantages2. Therefore, the choice of therapy requires a careful examination, where the available scientific data, the experience of the clinician as well as the characteristics and preferences of the individual patient are balanced and together determine the decision3. However, all treatment options, including the option not to operate, should always have their advantages and disadvantages to make space for the patient’s preferences.
In the meantime, it has been recognized that these principles are difficult to apply in daily clinical practice4.,5 To begin with, the clinicians’ expertise may be restricted due to the absence of treatment experience or inaccessibility of certain treatment methods in hospital. Secondly, it is doubtful to what extent the patient’s individual preferences are recognized as an ethical imperative, and to what extent the patients are actually actively involved4,5. In this context, collaborative decision making (SDM) is seen as a model for clinical practice6. and was defined by Weston WW. in 2001 as being one of the key components of patient-centered care 7. Interest in patient participation in SDM has increased in recent years8, which represents a shift from the paternalistic healthcare model to a person-centered health care approach. This patient‒physician alliance results in empowering patients to develop their autonomy 9,10 and in finding better healthcare choices. According to Stiggelbout AM et al. (2012), this approach brings more benefits in healthcare and fewer variations in practice.11
Gartner et al. (2018) in a literature search identified 16 existing patient profiles related to SDM 12. A general nine-point decision-making questionnaire is one of the most commonly used tools to assess the extent to which doctors involve patients in the decision-making process. It consists of versions of the patient (SDM-Q-9) and the doctor (SDM-Q-Doc), which can be used to evaluate the patient’s involvement in decision-making process from two points of view13,14. It is often used in various clinical situations, including primary and special care 15. Since 2009 it has been translated into many languages, including Romanian13.16.
Although SDM has become a priority of health policy in many European countries in the past two decades17, there are no studies on the involvement of patients in medical decisions in the Republic of Moldova.
Our goal was to examine the involvement of patients and physicians in the SDM process in the treatment of strabismus; the correlation between patient satisfaction and postsurgical outcome.