Shared decision-making in the Netherlands: Progress is made, but not for all. Time to become inclusive to patients

Kraan, Josine van der; Brand, Paul; Veenendaal, Haske van; Drenthen, Ton; Schoon, Yvonne; Tuyn, Eline; Weele, Gerda van der; Stalmeier, Peep F. M.; Damman, Olga C.; Stiggelbout, Anne M.

doi:10.1016/j.zefq.2022.04.029

Cited by 15 publications

(12 citation statements)

References 48 publications

(46 reference statements)

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“…All identified skills and competencies to fulfil the professional shared decision‐making roles are in line with the generic and core‐enabling competencies described in both the medical training framework for physicians and the nursing domain (Dutch Federation of University Medical Centers, 2020; Lambregts et al, 2016). However, an inventory of 78 curricula for medical students, nurses and postgraduate medical trainees in the Netherlands showed that in only 19 curricula shared decision‐making was addressed (Van der Weijden et al, 2022). For example, shared decision‐making was not mentioned in the curricula of cardiothoracic surgery and cardiology (Dutch Association of Cardiology, 2018; Dutch Association of Thoracic surgery, 2018).…”

Section: Discussionmentioning

confidence: 99%

Roles and competencies of nurses and physicians in shared decision‐making in cardiac surgery: A scoping review

Paans

Mariani

Dieperink

et al. 2023

Journal of Advanced Nursing

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AimIdentification and synthesis of research data related to the roles and competencies of physicians and nurses that are prerequisites for careful shared decision‐making with patients potentially undergoing cardiac surgery.DesignA scoping review was conducted in accordance with the Joanna Briggs Institute's methodology for scoping reviews and the PRISMA Extension for Scoping Reviews.MethodsPubMed, EMBASE and CINAHL were searched from inception dates up to March 2022, to identify primary studies published in a peer‐reviewed journal. Study selection, assessment of the methodological quality and data extracting of the included studies were done by at least two independent researchers. To describe the findings of the studies, an emergent synthesis approach was used to visualize a descriptive representation of professional roles and competencies in shared decision‐making, in an overview.ResultsThe systematic search revealed 10,055 potential papers, 8873 articles were screened on title and abstract and 76 full texts were retrieved. Eight articles were included for final evaluation. For nurses and physicians, 26 different skills were identified in the literature to practice shared decision‐making in cardiac surgery. The skills that emerged were divided into five professional roles: moderator; health educator; data collector; psychological supporter and translator.ConclusionsThis review specifies the professional roles and required competencies related to shared decision‐making in cardiac surgery. Further research is needed to compare our findings with other clinical areas and from there to arrive at a professional division of roles between the different clinical disciplines involved.ImpactThe visualization of generic shared decision‐making competencies and roles should establish the professional division of positions between various clinical physician and nurse disciplines in order to create a treatment plan based on evidence, values, preferences and the patient's personal situation.Patient or Public ContributionNo patient or public contribution.

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Section: Discussionmentioning

confidence: 99%

Roles and competencies of nurses and physicians in shared decision‐making in cardiac surgery: A scoping review

Paans

Mariani

Dieperink

et al. 2023

Journal of Advanced Nursing

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“…During the COVID-19 pandemic, the focus shifted from patients as sole clients of healthcare organizations to strengthen their role as direct strategic partners in the decisionmaking process [60]. This fits in with the concepts of patient-centered care (PCC) and shared decision making, which are gaining more and more recognition worldwide and, in many countries, are being implemented as standards in medical care [61][62][63][64][65][66][67]. Patient-centered care is defined as care delivery that respects and integrates patients' wants, needs, and preferences into goal setting and treatment [68].…”

Section: The Dimensions Of the Quality Of Health Servicesmentioning

confidence: 93%

A Crisis in the Health System and Quality of Healthcare in Economically Developed Countries

Biel

Grondys

Androniceanu

2022

IJERPH

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A health crisis caused by a pandemic tested the effectiveness of national healthcare systems by testing both financing and organizational and technical performance of patient care. At that time, the structural flaws in healthcare systems and inequalities in the level of healthcare in its different dimensions and countries due to resource constraints were highlighted. Therefore, the paper concentrates on investigating how the crisis in the health system affects the quality of healthcare services as a result of changes in the availability of financial, material, and human resources belonging to this system. The quantitative data, in terms of healthcare characterizing the OECD countries and selected non-member economies, treated as an example of economically developed regions, were chosen for the analysis. The study included five areas of resources, i.e., demographic, financial, human, technical, and the delivery of basic services in healthcare. T-test method for dependent samples, supplemented with Hedge’s g statistics, was applied to test the differences between the mean values of individual indicators. The results indicate the occurrence of changes in some areas of the healthcare system due to a crisis. Identifying areas that are particularly vulnerable to sudden changes in the healthcare system helps to understand which resource areas need to be strategically managed first, as shifts in levels respond to deteriorating healthcare quality outcomes.

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“…Additionally, patients indicated that nurses should be sensitised to involve patients in the decision‐making process (Galletta et al., 2022). In the Netherlands, where SDM has received much attention—including through a national campaign called ‘To Decide Together’—behavioural and cultural change in decision‐making is still ongoing (Van Der Weijden et al., 2022). Further implementation of SDM to nurture the motivation of professionals is being attempted by the nursing professional association in nursing care (Van Der Weijden et al., 2022).…”

Section: Introductionmentioning

confidence: 99%

Patients' experiences of shared decision‐making in nursing care: A qualitative study

Van Der Ploeg‐Dorhout,

Van Den Boogaard,

Reinders‐Messelink

et al. 2024

Journal of Clinical Nursing

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AimTo explore patients' experiences of shared decision‐making, in nursing care during their stay in a healthcare institution.DesignThis study employed a qualitative descriptive design.MethodsTwenty participants were interviewed from two rehabilitation centres, a nephrology ward of a hospital, and a rehabilitation ward of a long‐term care facility. A constant comparative method was used for the inductive analysis.ResultsThe main theme was ‘feeling seen and understood’, in the context of person‐centred care, which served as the unifying thread across five themes. The five themes included the importance of a positive nurse–patient relationship as a foundation for shared decision‐making. Next, patients experienced collaboration, and this was influenced by verbal and non‐verbal communication. Another theme was that patients often felt overwhelmed during their stay, affecting shared decision‐making. The fourth theme was that many decisions were not made through the shared decision‐making process but were still perceived as satisfactory. The final theme highlighted patients' perspectives on their role in decision‐making and influencing factors.ConclusionPatients describe how feeling seen and understood is a prerequisite for shared decision‐making as a part of person‐centred care. For nurses, this implies that they should focus on aspects such as building a good relationship and acknowledgement of patients' feelings and circumstances, next to empowering patients to feel knowledgeable and valued. This way patient's motivation to participate in shared decision‐making will be enhanced.Reporting MethodFollowing the EQUATOR guidelines, reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).Patient or Public ContributionPatients were involved in the study through interviews during the research process and member checks during analysis.Implications for the profession and/or patient careBefore initiating shared decision‐making processes, prioritise making the patient feel seen and understood. Be mindful that patients often feel overwhelmed during their stay. Use a person‐centred approach to make patients feel knowledgeable—this empowers them for shared decision‐making.ImpactResearch on patients' experiences of shared decision‐making in nursing care is limited, yet crucial for understanding patients' needs in shared decision‐making. This study highlights patients' perceptions that shared decision‐making is best facilitated within the nurse–patient relationship by nurses who primarily focus on ensuring that patients feel acknowledged and understood.

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Shared decision-making in the Netherlands: Progress is made, but not for all. Time to become inclusive to patients

Cited by 15 publications

References 48 publications

Roles and competencies of nurses and physicians in shared decision‐making in cardiac surgery: A scoping review

Roles and competencies of nurses and physicians in shared decision‐making in cardiac surgery: A scoping review

A Crisis in the Health System and Quality of Healthcare in Economically Developed Countries

Patients' experiences of shared decision‐making in nursing care: A qualitative study

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