Physicians' perceptions of shared decision‐making behaviours: a qualitative study demonstrating the continued chasm between aspirations and clinical practice

Abstract

Background Shared Decision Making (SDM) is a process of engaging patients in health decisions that involve multiple medically appropriate treatment options. Despite growing public and policy support for patient engagement in health decisions, SDM is not widely practiced in clinical settings.

The Physician‐as‐Stakeholder: An Exploratory Qualitative Analysis of Physicians’ Motivations for Using Shared Decision Making in the Emergency Department

“…We also incorporated findings from qualitative studies of non-EPs, due to the paucity of related studies with EPs. [25][26][27][28] Table 1 demonstrates how the theoretical framework guided the development of the interview guide. The interview guide was piloted and was then iteratively revised during the interview process (Data Supplement S1, available as supporting information in the online version of this paper).…”

Physician attitudes toward shared decision making: A systematic review

“…as the authors state, where guidelines exist recommending one treatment option, physicians may feel pressured to follow such recommendations, and thus may be less likely to seek involvement from their patient [32]. One qualitative study of 20 physicians found that support for SDM was most common among those who had received training in SDM related communication skills [33]. Conversely, those who worked under physicians who did not Table 3 Factors associated with support or lack of support for patient involvement in decision making.…”

PCI Choice Decision Aid for Stable Coronary Artery Disease

“…10,33,34 The failure to improve decisional quality and SDM in this trial supports the hypothesis that effective patient engagement involves specific clinician behaviors that are learned or prompted. 35,36 This raises the question of whether an intervention must include more deliberate methods to alter clinicians' current healthcare delivery patterns to lead to elicitation and integration of patient values and preferences. Many clinicians feel they already perform SDM regularly; yet, data suggest that attitudes are often not aligned, 35,36 and there is little evidence of proficiency in SDM skills.…”

“…35,36 This raises the question of whether an intervention must include more deliberate methods to alter clinicians' current healthcare delivery patterns to lead to elicitation and integration of patient values and preferences. Many clinicians feel they already perform SDM regularly; yet, data suggest that attitudes are often not aligned, 35,36 and there is little evidence of proficiency in SDM skills. 37 Importantly, the high scores on 2 items from the OPTION scale that focused on patient education suggested that the decision aid was often used as an educational pamphlet rather than a tool to facilitate a shared conversation.…”