Applying Theory of Planned Behavior to Understand Physicians’ Shared Decision-Making With Patients With Acute Respiratory Infections in Primary Care: A Cross-Sectional Study

Abstract

Background: To understand the physicians’ shared decision-making behavior (SDM) with patients with acute respiratory infections (ARIs) based on the theory of planned behavior (TPB) and identify barriers to the implementation of SDM in primary care.Methods: A cross-sectional study of 617 primary care physicians was conducted in primary facilities in Hubei province, China from December 2019 to January 2020. A self-administered questionnaire based on TPB theory was applied for measuring the physicians’ SDM behavior with patients presenting with ARIs.Results: The proposed TPB model revealed that attitude and subjective norms predicted behavior intention, and behavior intention was one significant predictor of SDM behavior (p < 0.001). After controlling for physicians’ demographic characteristics, receiving training regarding antibiotics was significantly associated with physicians’ attitudes toward SDM, while educational level and gender were significantly associated with physicians’ intention of engaging in SDM (p < 0.05). Physicians’ perceptions of patients’ expectations and incapability of making decisions were the most frequently reported barriers to the implementation of SDM.Conclusion: The TPB theory provides insights for understanding physicians’ SDM behavior with patients with ARIs in primary care. Since attitudes, subjective norms, and behavior intention were demonstrated as significant predictors of SDM behavior, these may be a promising focus of SDM interventions based on TPB theory. The results of the TPB model and potential barriers of SDM behavior would help determine future directions for SDM training and educating the public.

WITHDRAWN: Factors affecting the application of the value-based care principle in patient care among sixth-year medical students and postgraduate trainees

“…Previous evidence has shown that TPB can be used to understand health-related behaviours 18,19 and medical education. [20][21][22] Research has shown that in medical students, attitude and subjective norms predict behaviour intention, which is a signi cant predictor of shared decision-making behaviour. 20 Additionally, attitudes, subjective norms, and perception of behavioural control have been found to be important factors that in uence healthcare professionals' intention to engage in VBC practices.…”

“…[20][21][22] Research has shown that in medical students, attitude and subjective norms predict behaviour intention, which is a signi cant predictor of shared decision-making behaviour. 20 Additionally, attitudes, subjective norms, and perception of behavioural control have been found to be important factors that in uence healthcare professionals' intention to engage in VBC practices. 22 In this study, a cross-sectional survey with an online questionnaire was conducted among sixth-year medical students and postgraduate trainees in the Faculty of Medicine at…”

Addressing Antimicrobial Stewardship in Primary Care—Developing Patient Information Sheets Using Co-Design Methodology

“…Complex diagrams and numbers were not favoured as they were confusing to some. Tools such as patient information sheets and decision aids that contain relevant information can therefore assist patients in the decision process [ 13 , 23 , 24 ].…”