Step 1: Identify the decision(s)

What is the decision (including the option of doing nothing) and where does the decision occur within the process of care? Or are there points within the process of care when decisions need to be made? What are the decision(s) that patients have difficulty making?

1.1 Patient's view
What is the decision (including the option of doing nothing)? Where does the decision occur within the process of care?

For example: when someone receives a diagnosis, often there is a need to make a decision about treatment. Someone with a chronic condition may need to make a decision about changing the approach to managing the condition.

1.2 Health professional's view
What are the decision(s) that patients have difficulty making? Where does it occur in the process of care?

For example: parents of children with short stature often express difficulty about whether or not to initiate growth hormones.

1.3 Health services view
Are there points within the process of care when decisions need to be made? What are the decision(s)?

For example: when during the process of care for someone having a joint replacement for arthritis of the knee does the decision about surgery get made?

1.4 More formal approaches to identifying the decision(s)

1. Survey of patients' decision making needs
   Conduct a population needs assessment to identify patients' and health professionals' perception of patients' decision making needs using a workbook of key questions based on the Ottawa Decision Support Framework.
2. Review literature on decision making needs
   Conduct a systematic review of the scientific literature to identify systematic reviews and/or original studies of patients' and health professionals' decision making needs.

Examples of additional resources

Jackson C, Cheater FM, Reid I. (2008). A systematic review of decision support needs of parents making child health decisions. Health Expect. 11(3):232-251.

Murray MA, Brunier G, Chung JO, Craig LA, Mills C, Thomas A, Stacey D. (2009). A systematic review of factors influencing decision-making in adults living with chronic kidney disease. Patient Educ Couns. 76(2):149-158.

O'Connor AM, Drake ER, Wells GA, Tugwell P, Laupacis A, Elmslie T. (2003). A survey of the decision making needs of Canadians faced with complex health decisions. Health Expect. 6(2):97-109.

Stacey D, Menard P, Gaboury I, Jacobsen M, Sharif F, Ritchie L, Bunn H. (2008). Decision making needs of patients with depression: A descriptive study. J Psychiatr Ment Health Nurs. 15(4):287-295.