Clinicians perspectives towards the application of shared decision making in tertiary CVD care including the multidisciplinary heart team

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-03-26 DOI:10.1016/j.ijcha.2025.101657

Mirjam M. Garvelink , Tom Oirbans , Lea M. Dijksman , Paul B. van der Nat , Dennis van Veghel , Daniela N. Schulz , Marcel G.W. Dijkgraaf , Lucas V.A. Boersma

{"title":"Clinicians perspectives towards the application of shared decision making in tertiary CVD care including the multidisciplinary heart team","authors":"Mirjam M. Garvelink , Tom Oirbans , Lea M. Dijksman , Paul B. van der Nat , Dennis van Veghel , Daniela N. Schulz , Marcel G.W. Dijkgraaf , Lucas V.A. Boersma","doi":"10.1016/j.ijcha.2025.101657","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Shared decision-making (SDM), is a sine qua non in healthcare. Yet, it has been difficult to implement SDM in routine practice for patients with cardiovascular disease(CVD). To improve this, we aimed to determine HCPs perspectives on their SDM behavior in CVD context and influencing factors, and with special focus on multidisciplinary heartteams.</div></div><div><h3>Methods</h3><div>Cross-sectional survey between March-July 2022 with cardiologists, cardiothoracic surgeons, medical residents, and nurse practitioners within two of the largest tertiary cardiac Centers in the Netherlands. Descriptive statistics were used for quantitative data; open-ended questions were thematically analyzed.</div></div><div><h3>Results</h3><div>72 participants completed the survey. Respondents indicated to know “very well” what SDM entailed (70 %) and had positive attitudes towards SDM (90 %). Participants used SDM in daily practice (SDMQDoc = 73/100), but indicated that more SDM could be performed (67 %). In self-reported definitions of SDM, explaining the consequences of treatment (step 2) and discussing patients’ preferences (step 3) were most frequently mentioned. Barriers for SDM were patient and process characteristics: e.g. lack of time (70 %), understaffing (35 %). The heartteam was seen as potential facilitator, but its current role and process were seen as barrier for SDM. Facilitators for SDM were managerial support (16 %), decision aids (28 %), and SDM-training (13 %).</div></div><div><h3>Conclusion</h3><div>HCPs reported high knowledge and application of SDM, but overlooked some steps in the SDM-process. A multifaceted intervention is needed focusing on awareness, enhancing communication skills and system level support. Specific improvements were identified to improve SDM for patients discussed by the multidisciplinary heartteam.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101657"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJC Heart and Vasculature","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352906725000600","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Shared decision-making (SDM), is a sine qua non in healthcare. Yet, it has been difficult to implement SDM in routine practice for patients with cardiovascular disease(CVD). To improve this, we aimed to determine HCPs perspectives on their SDM behavior in CVD context and influencing factors, and with special focus on multidisciplinary heartteams.

Methods

Cross-sectional survey between March-July 2022 with cardiologists, cardiothoracic surgeons, medical residents, and nurse practitioners within two of the largest tertiary cardiac Centers in the Netherlands. Descriptive statistics were used for quantitative data; open-ended questions were thematically analyzed.

Results

72 participants completed the survey. Respondents indicated to know “very well” what SDM entailed (70 %) and had positive attitudes towards SDM (90 %). Participants used SDM in daily practice (SDMQDoc = 73/100), but indicated that more SDM could be performed (67 %). In self-reported definitions of SDM, explaining the consequences of treatment (step 2) and discussing patients’ preferences (step 3) were most frequently mentioned. Barriers for SDM were patient and process characteristics: e.g. lack of time (70 %), understaffing (35 %). The heartteam was seen as potential facilitator, but its current role and process were seen as barrier for SDM. Facilitators for SDM were managerial support (16 %), decision aids (28 %), and SDM-training (13 %).

Conclusion

HCPs reported high knowledge and application of SDM, but overlooked some steps in the SDM-process. A multifaceted intervention is needed focusing on awareness, enhancing communication skills and system level support. Specific improvements were identified to improve SDM for patients discussed by the multidisciplinary heartteam.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.