Table 1.

Existing frameworks for shared decision-making, and a priori codes: Three Talk Model for Shared Decision Making^22,23 and the Ottawa Decision Support Framework.²⁴.

Framework element/code	Framework element/code definition	Example interview guide questions/probes
The Three Talk Model for Shared Decision Making
Choice talk	Conveys awareness that a choice exists – initiated by either a patient or a clinician. This may occur before the clinical encounter.	What decisions needed to be made about the design of your first prosthesis?
Option talk	Patients are informed about treatment options in more detail.	How do you discuss pros and cons of prosthesis design options?
Decision talk	Patients are supported to explore ‘what matters most to them’, having become informed.	How are prosthesis design decisions made for a first prosthesis?
Initial preferences	Awareness of options leads to the development of initial preferences, based on existing knowledge. The goal is to arrive at informed preferences.	What did you know about prosthetics?
Informed preferences	Personal preferences based on ‘what matters most to patients’, predicated on an understanding of the most relevant benefits and harms.	What information did you need/want?
Deliberation	A process where patients become aware of choice, understand their options and have the time and support to consider ‘what matters most to them’: may require more than one clinical contact not necessarily face-to-face, and may include the use of decision support and discussions with others.	How did you determine the best options for you with your provider?
The Ottawa Decision Support Framework
Decision type	Class or characteristic of the choice that needs to be made [e.g. developmental transition or clinical options (screen, test, treat, palliate), number of options, degree of risk/uncertainty, seriousness of outcomes, margin for error (i.e. whether it is irrevocable)].	What decisions needed to be made about the design of your first prosthesis?
Decision timing	Time frame or urgency with which a decision needs to be made.	How were prosthesis design decisions made with your prosthetist?
Decision stage	Stages of decision making: not thinking about options; actively thinking about options; close to making a choice; and taking steps or already implementing the chosen option. Deciding not to change or to do nothing may be a viable option.	How were prosthesis design decisions made with your prosthetist?
Decision learning	Inclination to choose one option over the others.	How did you determine the best options for you with your provider?
Decision conflict/uncertainty	Uncertainty about which course of action to take when choice among competing actions involves risk, loss, regret, or challenge to personal life values. (Specify the focus of conflict, such as personal health, family relationships, career, finances, or other life events).	What uncertainties do you have about prosthesis design decisions?
Knowledge	Understanding of the health problem or situation, options, and outcomes (e.g. benefits, harms).	What information did you need/want?
Expectations	Perceptions of the likelihood or probability of outcomes for each option.	What were your expectations for your prosthesis?
Values	Desirability of, or personal importance attached to outcomes of options.	How do you determine what is important to patients for prosthesis design?
Support	Structured assistance in thinking about the decision and communicating with others (including needed/missing support).	What would be helpful for communicating with your prosthetist about prosthesis design decisions?
Resources	Available, accessible assets that are required to make and implement the decision (including needed/missing resources).	What is important for considering prosthesis design options?
Personal & clinical needs	Age, gender, education, marital status, ethnicity, occupation, locale, diagnosis & duration of condition, health status (physical, emotional, cognitive, social), socio-economic status, and social capital.	Tell me about your amputation and how you started working with your prosthetist.