Professionals' views on shared decision-making in severe aortic stenosis.

Autor:	van Beek-Peeters JJAM; Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands jvanbeek1@amphia.nl., van der Meer JBL; Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands.; Erasmus Medical Center, Rotterdam, The Netherlands., Faes MC; Geriatrics, Amphia Hospital, Breda, The Netherlands., de Vos AJBM; Amphia Academy, Amphia Hospital, Breda, The Netherlands.; Academy of Nursing Science and Education, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., van Geldorp MWA; Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands., Van den Branden BJL; Interventional Cardiology, Amphia Hospital, Breda, The Netherlands., Pel-Littel RE; Vilans, Centre of Expertise for Long-term Care, Utrecht, The Netherlands., van der Meer NJM; TIAS School for Business and Society, Tilburg University, Tilburg, The Netherlands.; Catharina Hospital, Eindhoven, The Netherlands., Minkman MMN; Vilans, Centre of Expertise for Long-term Care, Utrecht, The Netherlands.; TIAS School for Business and Society, Tilburg University, Tilburg, The Netherlands.
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2022 Apr; Vol. 108 (7), pp. 558-564. Date of Electronic Publication: 2021 Dec 24.
DOI:	10.1136/heartjnl-2021-320194
Abstrakt:	Objective: To provide insight into professionals' perceptions of and experiences with shared decision-making (SDM) in the treatment of symptomatic patients with severe aortic stenosis (AS). Methods: A semistructured interview study was performed in the heart centres of academic and large teaching hospitals in the Netherlands between June and December 2020. Cardiothoracic surgeons, interventional cardiologists, nurse practitioners and physician assistants (n=21) involved in the decision-making process for treatment of severe AS were interviewed. An inductive thematic analysis was used to identify, analyse and report patterns in the data. Results: Four primary themes were generated: (1) the concept of SDM, (2) knowledge, (3) communication and interaction, and (4) implementation of SDM. Not all respondents considered patient participation as an element of SDM. They experienced a discrepancy between patients' wishes and treatment options. Respondents explained that not knowing patient preferences for health improvement hinders SDM and complicating patient characteristics for patient participation were perceived. A shared responsibility for improving SDM was suggested for patients and all professionals involved in the decision-making process for severe AS. Conclusions: Professionals struggle to make highly complex treatment decisions part of SDM and to embed patients' expectations of treatment and patients' preferences. Additionally, organisational constraints complicate the SDM process. To ensure sustainable high-quality care, professionals should increase their awareness of patient participation in SDM, and collaboration in the pathway for decision-making in severe AS is required to support the documentation and availability of information according to the principles of SDM. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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