دورية أكاديمية
أعرض في EDS

Unravelling clinicians' shared decision-making adoption: a qualitative exploration through the lens of diffusion of innovations theory.

التفاصيل البيبلوغرافية
العنوان: Unravelling clinicians' shared decision-making adoption: a qualitative exploration through the lens of diffusion of innovations theory.
المؤلفون: Spinnewijn L; Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands lauraspinnewijn@gmail.com.; VU Amsterdam Athena Institute, Amsterdam, North Holland, The Netherlands., Aarts JW; Gynaecological Oncology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands., Braat D; Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands., Scheele F; VU Amsterdam Athena Institute, Amsterdam, North Holland, The Netherlands.; Obstetrics and Gynaecology, OLVG, Amsterdam, Noord-Holland, The Netherlands.
المصدر: BMJ open [BMJ Open] 2024 Jun 21; Vol. 14 (6), pp. e080765. Date of Electronic Publication: 2024 Jun 21.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Qualitative Research* , Diffusion of Innovation* , Decision Making, Shared*, Humans ; Female ; Netherlands ; Male ; Attitude of Health Personnel ; Obstetrics ; Gynecology ; Physician-Patient Relations ; Adult ; Patient Participation ; Interviews as Topic
مستخلص: Objectives: This study uses the diffusion of innovations (DOI) theory to comprehensively understand the adoption of shared decision-making (SDM) in clinical practice, specifically focusing on the 'knowledge' and 'persuasion' stages within DOI. We aim to understand the challenges and dynamics associated with SDM adoption, offering insights for more patient-centred decision-making in healthcare.
Design: This qualitative study employs a modified framework analysis approach, integrating ethnographic and interview data from prior research, along with additional interviews. The framework used is based on the DOI theory.
Study Setting and Participants: This study was conducted in the obstetrics and gynaecology department of a tertiary teaching hospital in the Eastern region of the Netherlands. It included interviews with 20 participants, including gynaecologists, obstetrics registrars and junior doctors currently practising in the department. Additionally, data from prior research conducted within the same department were incorporated, ensuring the maintenance of contextual consistency.
Results: Findings reveal a complex interplay between SDM's benefits and challenges. Clinicians value SDM for upholding patient autonomy and enhancing medical practice, viewing it as valuable for medical decision-making. Decision aids are seen as advantageous in supporting treatment decisions. Challenges include compatibility issues between patient and clinician preferences, perceptions of SDM as time-consuming and difficult and limitations imposed by the rapid pace of healthcare and its swift decisions. Additionally, perceived complexity varies by situation, influenced by colleagues' attitudes, with limited trialability and sparsely observed instances of SDM.
Conclusions: Clinicians' decision to adopt or reject SDM is multifaceted, shaped by beliefs, cognitive processes and contextual challenges. Cognitive dissonance is critical as clinicians reconcile their existing practices with the adoption of SDM. Practical strategies such as practice assessments, open discussions about SDM's utility and reflective practice through professional development initiatives empower clinicians to make the best informed decision to adopt or reject SDM.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: Change management; Decision Making; GYNAECOLOGY; OBSTETRICS; Patient Participation; Patient-Centered Care
تواريخ الأحداث: Date Created: 20240622 Date Completed: 20240622 Latest Revision: 20240818
رمز التحديث: 20240818
مُعرف محوري في PubMed: PMC11328636
DOI: 10.1136/bmjopen-2023-080765
PMID: 38908847
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2023-080765