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.