The impact of a patient decision aid on shared decision‐making behaviour in oncology care and pulmonary medicine—A field study based on real‐life observations

Olling, Karina; Stie, Mette; Winther, Bodil; Steffensen, Karina Dahl

doi:10.1111/jep.13196

Cited by 22 publications

(27 citation statements)

References 23 publications

(50 reference statements)

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“…As a result, SDM and PDA uptake may fail to be sustained over time [ 24 ]. Within this context, we studied SDM implementation at Vejle Hospital, Denmark, where, under the leadership of the Center for Shared Decision Making, SDM and PDAs have been implemented with considerable success [ 11 – 13 ]. The purpose of this qualitative study was to examine practitioners’ experiences of the Center’s efforts to introduce SDM and PDAs into clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…There was a pronounced difference in our results in how clinicians and nurses viewed patient participation; nurses were enthusiastic about SDM due to their first-hand experience seeing the consequences of not taking patients’ wishes into account in treatment decisions, whereas for clinicians this shift happened after working with patients on developing the PDAs and was reinforced through repeated application of SDM principles. Previous findings from the Center have shown that pre-implementation OPTION scores indicated lower levels of SDM [ 11 ]. Communicating this disparity to clinicians may be the first step in shifting attitudes, as clinicians’ perception that SDM improves their practice makes sustained implementation more likely [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…With a focus on improving patient-centeredness in oncology, the Center successfully implemented and evaluated SDM, supported by patient decision aids (PDAs) in paper format, in the care process for several cancer patient groups, to the extent that it is now being used as a model for wider regional implementation. Evaluations of the Center’s SDM initiative have shown an increase in patient engagement with no significant increase in consultation length in SDM groups compared to usual care in lung cancer and breast cancer, as well as significant reductions in decisional conflict and decisional regret for patients undergoing lung cancer diagnostics [ 11 – 13 ]. In addition, in a Danish national survey of patient experiences, patients rated Vejle Hospital’s oncology center above the national average on most fronts, particularly clinician efforts to involve patients in decisions [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Practitioners’ views on shared decision-making implementation: A qualitative study

et al. 2021

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Introduction Shared decision-making (SDM) refers to the collaboration between patients and their healthcare providers to make clinical decisions based on evidence and patient preferences, often supported by patient decision aids (PDAs). This study explored practitioner experiences of SDM in a context where SDM has been successfully implemented. Specifically, we focused on practitioners’ perceptions of SDM as a paradigm, factors influencing implementation success, and outcomes. Methods We used a qualitative approach to examine the experiences and perceptions of 10 Danish practitioners at a cancer hospital experienced in SDM implementation. A semi-structured interview format was used and interviews were audio-recorded and transcribed. Data was analyzed through thematic analysis. Results Prior to SDM implementation, participants had a range of attitudes from skeptical to receptive. Those with more direct long-term contact with patients (such as nurses) were more positive about the need for SDM. We identified four main factors that influenced SDM implementation success: raising awareness of SDM behaviors among clinicians through concrete measurements, supporting the formation of new habits through reinforcement mechanisms, increasing the flexibility of PDA delivery, and strong leadership. According to our participants, these factors were instrumental in overcoming initial skepticism and solidifying new SDM behaviors. Improvements to the clinical process were reported. Sustaining and transferring the knowledge gained to other contexts will require adapting measurement tools. Conclusions Applying SDM in clinical practice represents a major shift in mindset for clinicians. Designing SDM initiatives with an understanding of the underlying behavioral mechanisms may increase the probability of successful and sustained implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Practitioners’ views on shared decision-making implementation: A qualitative study

et al. 2021

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“…Some patients are reluctant to assert their care preferences to clinicians, especially in the face of critical illness. Karina Olling et al report from Denmark their “before and after” study of the effect of a patient decision aid on SDM in this context. Applying a validated tool, the OPTION scale, experienced oncology nurses independently observed decision support to facilitate patient‐centred communication in real life.…”

Section: Shared Decision Makingmentioning

confidence: 99%

“…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 …”

Section: Introductionmentioning

confidence: 99%

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

Loughlin

Buetow

Cournoyea

et al. 2019

Evaluation Clinical Practice

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There is now broad agreement that ideas like person‐centred care, patient expertise and shared decision‐making are no longer peripheral to health discourse, fine ideals or merely desirable additions to sound, scientific clinical practice. Rather, their incorporation into our thinking and planning of health and social care is essential if we are to respond adequately to the problems that confront us: they need to be seen not as “ethical add‐ons” but core components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. This, the tenth philosophy thematic edition of the journal, presents papers conducting urgent research into the social context of scientific knowledge and the significance of viewing clinical knowledge not as something that “sits within the minds” of researchers and practitioners, but as a relational concept, the product of social interactions. It includes papers on the nature of reasoning and evidence, the on‐going problems of how to ‘integrate’ different forms of scientific knowledge 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 shared decision‐making, analysing its proper meaning, its role in policy, methods for realising it and its limitations in real‐world contexts.

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The impact of decision tools during oncological consultation with lung cancer patients: A systematic review within the I3LUNG project

Sebri,

Marzorati,

Dorangricchia

et al. 2024

Cancer Medicine

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IntroductionTo date, lung cancer is one of the most lethal diagnoses worldwide. A variety of lung cancer treatments and modalities are available, which are generally presented during the patient and doctor consultation. The implementation of decision tools to facilitate patient's decision‐making and the management of their healthcare process during medical consultation is fundamental. Studies have demonstrated that decision tools are helpful to promote health management and decision‐making of lung cancer patients during consultations. The main aim of the present work within the I3LUNG project is to systematically review the implementation of decision tools to facilitate medical consultation about oncological treatments for lung cancer patients.MethodsIn the present study, we conducted a systematic review following the PRISMA guidelines. We used an electronic computer‐based search involving three databases, as follows: Embase, PubMed, and Scopus. 10 articles met the inclusion criteria and were included. They explicitly refer to decision tools in the oncological context, with lung cancer patients.ResultsThe discussion highlights the most encouraging results about the positive role of decision aids during medical consultations about oncological treatments, especially regarding anxiety, decision‐making, and patient knowledge. However, no one main decision aid tool emerged as essential. Opting for a more recent timeframe to select eligible articles might shed light on the current array of decision aid tools available.ConclusionFuture review efforts could utilize alternative search strategies to explore other lung cancer‐specific outcomes during medical consultations for treatment decisions and the implementation of decision aid tools. Engaging with experts in the fields of oncology, patient decision‐making, or health communication could provide valuable insights and recommendations for relevant literature or research directions that may not be readily accessible through traditional search methods. The development of guidelines for future research were provided with the aim to promote decision aids focused on patients' needs.

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The impact of a patient decision aid on shared decision‐making behaviour in oncology care and pulmonary medicine—A field study based on real‐life observations

Cited by 22 publications

References 23 publications

Practitioners’ views on shared decision-making implementation: A qualitative study

Practitioners’ views on shared decision-making implementation: A qualitative study

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

The impact of decision tools during oncological consultation with lung cancer patients: A systematic review within the I3LUNG project

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