Perceptions of shared decision making among health care professionals

Abstract

Rationale and Aims Scholars have progressively promoted shared decision making (SDM) as an optimal model of treatment decision making in clinical practice. Nevertheless, it is unclear whether health care professionals (a) understand SDM well, (b) believe that SDM is helpful in their daily practice, and (c) are willing to practice SDM during their daily activities. These are crucial research topics; however, such research is still limited. The aim of this study was to apply the knowledge‐attitude‐behavior (KAB) model to probe health care professionals' perceptions of SDM. Methods A questionnaire was delivered to health care professionals working in various hospitals in southern Taiwan from 9 November 2018 to 8 January 2019. In addition to KAB constructs, this study explored the barriers to SDM practice and willingness to practice SDM among health care professionals. Predictive variables were subjected to multiple linear regression analysis to investigate health care professionals' views of SDM. Results Valid respondents numbered 400, including physicians, pharmacists, nurses, and other health care professionals. The characteristics of these health care professionals significantly affected the mean scores of the KAB model. A correlation analyses indicated that the KAB constructs were positively correlated with each other. The top three barriers reported were lack of time (57.50%), lack of knowledge (38.25%), and difficulty of developing patient decision aids (37.75%). Respondents who were willing to practice SDM opined that SDM can provide the best health care for patients (81.62%), can maintain and improve individual clinical expertise (77.38%), and can meet patient and social expectations (48.40%). Conclusions Continuous emphasis on education regarding SDM and continuous promotion of a positive attitude of SDM acceptance can influence the behaviour of practicing SDM among health care professionals. Further study is required to assess the SDM practices of various health care professionals in different settings.

What's the Role of Time in Shared Decision Making?

“…Studies have shown that both patients and clinicians view time constraints as a frequent and substantial barrier to SDM. 7,8,9,10,11 Prevailing sentiment among clinicians and patients is that there is an inherent tension between time and SDM.…”

Translation and psychometric evaluation of the German version of the IcanSDM measure – a cross-sectional study among healthcare professionals

“…This is notable since SDM is promoted by the German government and research for many years [ 71 – 74 ]. Several studies could show that HCPs often lack a full conceptual understanding of SDM while at the same time having a positive attitude towards SDM [ 33 , 75 – 79 ]. But it has to be kept in mind that limited knowledge about SDM might also be a barrier to perform SDM [ 79 ].…”

“…Several studies could show that HCPs often lack a full conceptual understanding of SDM while at the same time having a positive attitude towards SDM [ 33 , 75 – 79 ]. But it has to be kept in mind that limited knowledge about SDM might also be a barrier to perform SDM [ 79 ]. In terms of cross-cultural translation of a SDM measure, this underlines the importance of assessing knowledge about the construct and specific terms of the measure in the target language and compare it with the original language [ 38 ].…”

Interactions between persons—Knowledge, decision making, and the co‐production of practice

“…Min‐Chun Chung et al apply the Knowledge‐Attitude‐Behaviour model to probe perceptions of SDM in health care professionals working in various hospitals in southern Taiwan. Their study revealed positive attitudes to SDM and predictable barriers to its implementation, identified as lack of time and knowledge and the difficulty of developing patient decision‐aids: guides to SDM in specific contexts that can help clinicians work through a decision with their patients.…”

“…It includes papers on the nature of reasoning and evidence, the on‐going problems of how to “integrate” different forms of scientific knowledge with each other, and with broader, humanistic understandings of reasoning and judgement, patient and community perspectives . Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under‐developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on SDM, analysing its proper meaning, its role in policy, methods for realizing it and its limitations in real‐world contexts …”