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. 2021 Nov 11;16(11):e0259844.
doi: 10.1371/journal.pone.0259844. eCollection 2021.

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

Anshu Ankolekar  1 , Karina Dahl Steffensen  2   3   4 , Karina Olling  2 , Andre Dekker  1 , Leonard Wee  1 , Cheryl Roumen  1 , Hajar Hasannejadasl  1 , Rianne Fijten  1
Affiliations

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

Anshu Ankolekar et al. PLoS One. .

Abstract

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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Thematic map of themes and subthemes for each research question.
Solid lines indicate links between themes and subthemes, while dashed lines indicate relationships between themes.
See this image and copyright information in PMC

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