Knowledge, attitude and practice of shared decision-making among Indian physiotherapists

Authors

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20253699

Keywords:

Attitude, Evidence-based care, India, Knowledge, Physiotherapy, Practice, Shared decision-making

Abstract

Background: Shared decision-making (SDM) is a collaborative approach in which physiotherapists and patients jointly make treatment decisions by integrating clinical evidence with patient preferences. Shared decision making has been associated with improved rehabilitation outcomes globally yet its uptake in low- and middle-income countries like India remains unclear. Hence, the objective of this study was to assess the knowledge, attitude, and practice of shared decision-making among Indian physiotherapists.

Methods: Study incorporated a cross-sectional survey among 109 physiotherapists across India using a validated questionnaire assessing knowledge, attitudes of shared decision-making implementation across various clinical conditions, and real-world shared decision-making practices. Data were collected and analysed using descriptive statistics.

Results: While 99% of participants correctly identified the purpose of shared decision making only 3.66% demonstrated full knowledge, revealing a significant deficit. While attitudes were most favourable in chronic and orthopedic care, half viewed shared decision making as confusing or time consuming. Although many discussed conditions and treatment options with patients, 66% did not communicate evidence-based benefits and risks highlighting lack of evidence practice in patient-centred care.

Conclusions: The study revealed limited comprehensive knowledge but a generally positive attitude and partial adoption of shared decision-making practices among Indian physiotherapists. These findings highlight a need for targeted education and training to enhance evidence-based shared decision-making in physiotherapy practice.

Metrics

Metrics Loading ...

References

Resnicow K, Catley D, Goggin K, Hawley S, Williams GC. Shared decision making in health care: theoretical perspectives for why it works and for whom. Med Decision Making. 2022;42(6):755-64. DOI: https://doi.org/10.1177/0272989X211058068

Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361-7. DOI: https://doi.org/10.1007/s11606-012-2077-6

Hoffmann T, Bakhit M, Michaleff Z. Shared decision making and physical therapy: What, when, how, and why? Braz J Phys Ther. 2022;26(1). DOI: https://doi.org/10.1016/j.bjpt.2021.100382

Tilak RT, Vidyapeeth M, Tiku R. Ethical and legal considerations for physiotherapy practice in India. Int J Sci Res. 2023;12(6).

Srinivasan A, Somade O, Shivakumar K. An observational study on assessing involvement of rural Maharastrian adults of Satara district in shared decision-making regarding community health physiotherapy services. J Soc Indian Physiother. 2023;7(1):13. DOI: https://doi.org/10.4103/jsip.jsip_3_23

Hwee Heng CS. Collaborative goal setting in palliative rehabilitation: a case report. BMC Palliat Care. 2024;23(1):179. DOI: https://doi.org/10.1186/s12904-024-01506-3

Pel-Littel RE, Snaterse M, Teppich NM, Buurman BM, van Etten-Jamaludin FS, van Weert JC, et al. Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review. BMC Geriatr. 2021;21(1):112. DOI: https://doi.org/10.1186/s12877-021-02050-y

Grenfell J, Soundy A. People’s experience of shared decision making in musculoskeletal physiotherapy: a systematic review and thematic synthesis. Behav Sci. 2022;12(1). DOI: https://doi.org/10.3390/bs12010012

Grevnerts HT, Krevers B, Kvist J. Treatment decision-making process after an anterior cruciate ligament injury: patients’, orthopaedic surgeons’ and physiotherapists’ perspectives. BMC Musculoskelet Disord. 2022;23(1). DOI: https://doi.org/10.1186/s12891-022-05745-4

Moore CL, Kaplan SL. A framework and resources for shared decision making: opportunities for improved physical therapy outcomes. Phys Ther. 2018;98(12):1022-36. DOI: https://doi.org/10.1093/ptj/pzy095

Manhas KP, Olson K, Churchill K, Vohra S, Wasylak T. Experiences of shared decision-making in community rehabilitation: a focused ethnography. BMC Health Serv Res. 2020;20(1). DOI: https://doi.org/10.1186/s12913-020-05223-4

Mukamel DB, Haeder SF, Weimer DL. Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards. Ann Rev Public Health. 2014;35(1):477-97. DOI: https://doi.org/10.1146/annurev-publhealth-082313-115826

Smith CS. Applying a systems oriented ethical decision making framework to mitigating social and structural determinants of health. Front Oral Health. 2023;4. DOI: https://doi.org/10.3389/froh.2023.1031574

Doherr H, Christalle E, Kriston L, Haèrter M, Scholl I. Use of the 9-item shared decision making questionnaire (SDM-Q-9 and SDM-Q-Doc) in intervention studies: a systematic review. PLoS One. 2017;12(3). DOI: https://doi.org/10.1371/journal.pone.0173904

Alotaibi MA, Alhowimel AS, Alodaibi FA, Aloraifi M. The practice of shared decision-making among physiotherapists and patients with musculoskeletal conditions. J Multidiscip Healthc. 2023;16:2655-2665. DOI: https://doi.org/10.2147/JMDH.S425315

Lowe SW, Mackie DW. Shared decision-making in physical therapy: a scoping review. Phys Ther Rev. 2025:1-10.

Hoffmann T, Gibson E, Barnett C, Maher C. Shared decision making in Australian physiotherapy practice: a survey of knowledge, attitudes, and self-reported use. PLoS One. 2021;16(5):1. DOI: https://doi.org/10.1371/journal.pone.0251347

Choi BC, Pak AW. A catalog of biases in questionnaires. Preventing chronic disease. 2004;2(1):A13.

Andersson H, Svensson A, Frank C, Rantala A, Holmberg M, Bremer A. Ethics education to support ethical competence learning in healthcare: an integrative systematic review. BMC Med Ethics. 2022;23(1):1. DOI: https://doi.org/10.1186/s12910-022-00766-z

Downloads

Published

2025-10-31

How to Cite

Parthasarathi, B., Francis, S. K., P. H., S., & Raja, K. (2025). Knowledge, attitude and practice of shared decision-making among Indian physiotherapists. International Journal Of Community Medicine And Public Health, 12(11), 5159–5165. https://doi.org/10.18203/2394-6040.ijcmph20253699

Issue

Section

Original Research Articles