Shared challenges and opportunities: Uncovering common ground in patient participation across different healthcare settings and patient groups. A qualitative meta-summary on patient-reported barriers and facilitators to participation in shared decision-making

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2024-10-24 DOI:10.1016/j.pec.2024.108475

L. Mertens , T. Kasmi , GE Bekkering , K. Hannes , M. Vermandere , N. Delvaux , P. Van Bostraeten , J. Jaeken , T. van der Weijden , J. Rademakers , B. Aertgeerts

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引用次数: 0

Abstract

Objective

We aim to provide an updated literature overview on patient-reported barriers and facilitators to participation in SDM across different patient groups and healthcare settings to uncover the ‘common ground’ and to reach for a more generalizable, uniform and inclusive insight in patients’ perspective on participation in SDM.

Methodology

We conducted a qualitative meta-summary, using five databases. Search terms were based on the concepts: ‘decision-making’, ‘patient participation’, ‘patient perceptions’ and ‘study design’ (of patient reporting).

Results

We found 9265 unique references, selected 209 studies for further sampling and finally withheld 90 studies for further analysis in this review. In total, we identified 34 different barriers and facilitators. Based on most frequently reported barriers and facilitators, we defined four broad analytical themes corresponding to patients’ shared expectations concerning doctors’, patients’ and others’ facilitative roles in SDM: (1) ‘Doctors explaining well’, (2) ‘Doctors listening well, and fostering a trusting relationship’, (3) ‘Patients being assertive, (4) ‘Patients being socially supported’.

Conclusion

The majority of barriers and facilitators we found transcended differences in patient characteristics or healthcare setting, suggesting that patients are, overall, facing shared challenges and opportunities in SDM, that are mostly generalizable and irrespective of variabilities in decisional setting or patient group. We uncovered new trends such as patients’ growing openness to assertiveness and the involvement of significant others, and highlighted some culture-based nuances, compared to earlier literature.

Practice Implications

These new insights need to be integrated in SDM strategies so that they may serve the ethical imperative of a greater equality and inclusion of diverse patient groups in different SDM settings.

查看原文本刊更多论文

共同的挑战和机遇：发现不同医疗机构和患者群体中患者参与的共同点。关于患者报告的参与共同决策的障碍和促进因素的定性元总结

目的我们旨在对不同患者群体和医疗机构中患者报告的参与 SDM 的障碍和促进因素进行最新的文献综述，以发现 "共同点"，并对患者参与 SDM 的观点提出更具普遍性、统一性和包容性的见解。检索词基于以下概念："决策"、"患者参与"、"患者感知 "和 "研究设计"（患者报告）。结果我们找到了 9265 个唯一的参考文献，选择了 209 项研究作进一步取样，最后保留了 90 项研究，以便在本综述中作进一步分析。我们总共发现了 34 种不同的障碍和促进因素。根据最常报道的障碍和促进因素，我们定义了四个广泛的分析主题，分别对应患者对医生、患者和其他人在 SDM 中的促进作用的共同期望：（1）"医生解释得当"；（2）"医生善于倾听并建立信任关系"；（3）"患者有主见"；（4）"患者得到社会支持"。结论我们发现的大多数障碍和促进因素都超越了患者特征或医疗环境的差异，表明患者在 SDM 中总体上面临着共同的挑战和机遇，这些挑战和机遇大多具有普遍性，与决策环境或患者群体的差异无关。与之前的文献相比，我们发现了一些新的趋势，如患者对自信和重要他人参与的态度越来越开放，并强调了一些基于文化的细微差别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.