Implementation of a patient decision aid for discharge planning of hospitalized patients with stroke: aprocess evaluation using a mixed-methods approach

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

Patient Education and Counseling Pub Date : 2025-03-08 DOI:10.1016/j.pec.2025.108716

J.C.M. Prick , E.G. Engelhardt , F.K. Lansink Rotgerink , I.A. Deijle , S.M. van Schaik , M.M. Garvelink , R. Dahmen , P.J.A.M. Brouwers , I.W.M. van Uden , P.J. van der Wees , R.M. Van den Berg-Vos , C.F. van Uden-Kraan , On behalf of the Santeon VBHC STROKE group

{"title":"Implementation of a patient decision aid for discharge planning of hospitalized patients with stroke: aprocess evaluation using a mixed-methods approach","authors":"J.C.M. Prick , E.G. Engelhardt , F.K. Lansink Rotgerink , I.A. Deijle , S.M. van Schaik , M.M. Garvelink , R. Dahmen , P.J.A.M. Brouwers , I.W.M. van Uden , P.J. van der Wees , R.M. Van den Berg-Vos , C.F. van Uden-Kraan , On behalf of the Santeon VBHC STROKE group","doi":"10.1016/j.pec.2025.108716","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To promote shared decision-making (SDM) during discharge planning of patients with stroke, a patient decision aid (PtDA) was implemented in seven Dutch hospitals. This mixed-methods process evaluation assessed: 1) PtDA use, 2) the SDM process, 3) facilitators and barriers influencing health care professional (HCP) adoption of the PtDA, and 4) HCP experiences with the PtDA.</div></div><div><h3>Methods</h3><div>Rates of PtDA use were derived from hospital registries and PtDA log data. SDM levels in consultations were quantitatively assessed using OPTION-5 (score range 0–100); the SDM process was analyzed qualitatively. Facilitators and barriers were identified via the MIDI questionnaire. HCP experiences were explored through interviews.</div></div><div><h3>Results</h3><div>PtDA use varied across hospitals, with 10–96 % of patients receiving it and 27–100 % of those ultimately using it. OPTION-5 scores were low in both pre-implementation (<em>n</em> = 68, median:0, Q1-Q3:0–0) and post-implementation consultations (<em>n</em> = 49, median:0, Q1-Q3:0–15). Barriers included lack of whole-team engagement and limited recognition of PtDA benefits. Frequent PtDA use was associated with HCP confidence and self-efficacy in SDM.</div></div><div><h3>Conclusions</h3><div>Successful PtDA implementation in stroke care requires whole-team engagement, emphasis on PtDA benefits, and enhancing HCP confidence and self-efficacy in SDM.</div></div><div><h3>Practice implications</h3><div>Highlighting positive SDM outcomes and patient benefits may encourage HCPs to adopt the PtDA.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108716"},"PeriodicalIF":2.9000,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient Education and Counseling","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0738399125000837","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

To promote shared decision-making (SDM) during discharge planning of patients with stroke, a patient decision aid (PtDA) was implemented in seven Dutch hospitals. This mixed-methods process evaluation assessed: 1) PtDA use, 2) the SDM process, 3) facilitators and barriers influencing health care professional (HCP) adoption of the PtDA, and 4) HCP experiences with the PtDA.

Methods

Rates of PtDA use were derived from hospital registries and PtDA log data. SDM levels in consultations were quantitatively assessed using OPTION-5 (score range 0–100); the SDM process was analyzed qualitatively. Facilitators and barriers were identified via the MIDI questionnaire. HCP experiences were explored through interviews.

Results

PtDA use varied across hospitals, with 10–96 % of patients receiving it and 27–100 % of those ultimately using it. OPTION-5 scores were low in both pre-implementation (n = 68, median:0, Q1-Q3:0–0) and post-implementation consultations (n = 49, median:0, Q1-Q3:0–15). Barriers included lack of whole-team engagement and limited recognition of PtDA benefits. Frequent PtDA use was associated with HCP confidence and self-efficacy in SDM.

Conclusions

Successful PtDA implementation in stroke care requires whole-team engagement, emphasis on PtDA benefits, and enhancing HCP confidence and self-efficacy in SDM.

Practice implications

Highlighting positive SDM outcomes and patient benefits may encourage HCPs to adopt the PtDA.

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

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.