Through Clinicians Eyes: Use of an In-consultation Patient Decision Aid in Radiation Treatment for Early Breast Cancer. A Qualitative Study.

Autor: Søndergaard SR; Department of Oncology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark; Center for Shared Decision Making, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, Denmark. Electronic address: stine.rauff.sondergaard@rsyd.dk., Stie M; Department of Oncology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Bechmann T; Department of Oncology, Regional Hospital West Jutland, Herning, Denmark., Offersen BV; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark., Nielsen MH; Department of Oncology, Odense University Hospital, Odense, Denmark., Møller M; Department of Oncology, Aalborg University Hospital, Aalborg, Denmark., Berry LL; Texas A&M University, College Station, TX., Zachariae R; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Psychology and Behavioral sciences, Aarhus University, Aarhus, Denmark., Steffensen KD; Center for Shared Decision Making, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Lund L; Center for Shared Decision Making, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2024 Jun; Vol. 24 (4), pp. e297-e309. Date of Electronic Publication: 2024 Feb 21.
DOI: 10.1016/j.clbc.2024.02.009
Abstrakt: Introduction: Shared decision making (SDM) has become a crucial element on the political agenda and represents a vital aspect of modern healthcare. However, successful implementation of SDM highly depends on the attitude of clinicians towards SDM. The overall aim of our study was to explore the experience of oncologists and nurses with SDM using the Decision Helper, an in-consultation decision aid, at four Danish radiotherapy departments.
Methods: Semi-structured interviews were conducted with 20 clinicians. The participants were selected using purposive sampling to include nurses and oncologists, male and female, with different levels of experience with SDM and clinical work. The analysis was a data-driven, iterative process with inductive coding of all interviews and meaning condensation.
Results: Two main themes emerged: "Using the Decision Helper changes the consultation" and "Change of attitude among Danish oncologists." Each of the two themes included four elaborative subthemes, which are reported with supporting citations in this paper. In brief, the use of SDM and the Decision Helper should ideally be adjusted to the individual patient and depends highly on the oncologist. The participants described ambitions towards "making the right decision for this patient at this time." The healthcare system, however, has pitfalls that may hinder SDM, e.g., rigid interpretation of guideline-based recommendations.
Conclusion: Using an in-consultation Decision Helper has the potential for individualized, structured patient engagement in decision making. There is a need for patient decision aids in clinical guidelines to ensure patient engagement in decision making.
Competing Interests: Disclosure The authors have no conflicts of interest to declare.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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