Factors influencing autonomy supportive consultation: A realist review

Kors, Joyce; Paternotte, Emma; Martin, Linda; Verhoeven, Corine; Schoonmade, Linda J.; Peerdeman, Sakia M.; Kusurkar, Rashmi A.

doi:10.1016/j.pec.2020.04.019

Cited by 13 publications

(16 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 9 25 26 However, they used other mechanisms to build and protect their relationship with the patient than those that were presented in concepts and models on ASC. 10 The results show that the professionals included in our study protected their relationships by using minimising language, which reduces the seriousness of the conversation about decisions regarding pregnancy or delivery. 19 The professionals in our study also frequently used humour to convey a serious or emotional message, thus protecting the relationship while dealing with the patient’s discomfort.…”

Section: Discussionmentioning

confidence: 83%

“…We know from the literature that although it is important to provide professional guidance, professionals find it difficult to do so in an autonomy-supportive way because they are afraid to limit the patient’s autonomy. 10 Thus, compared with concepts and models on ASC, professionals seem to use other mechanisms to fulfil patients’ need for relatedness and only few mechanisms to meet patients’ need for competence and autonomy.…”

Section: Discussionmentioning

confidence: 99%

“…‘Autonomy’ (feeling of being the source of one’s own behaviours) can be enabled by exploring a patient’s needs and facilitating a patient’s free choice. Thus, healthcare professionals can apply different methods or ‘mechanisms’ to foster their patients’ self-regulated choices and behaviours 4 10…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

ObjectivesThe aim of this study was to identify mechanisms of autonomy-supportive consultation (ASC) that maternity care professionals use during decision-making in prenatal consultations.DesignThis study was a descriptive, qualitative analysis of professional–patient interactions in maternity care, using concepts and analytic procedures of conversation analysis.SettingThe prenatal consultations took place in hospitals and midwifery practices in the Netherlands. This study was part of a larger project. For the current study, we selected prenatal consultations concerning three topics in which patients make their own choices.ParticipantsThe first author invited the patient who was waiting in the waiting room. Participants were not selected a priori.Main outcome measuresThe main outcome measures were mechanisms of ASC.ResultsWe selected 20 consultations which were conducted by 20 different professionals. We found eight mechanisms in the professional–patient interaction which were categorised into three overarching themes. The first theme, ‘Lightheartedness’, comprises the interactional mechanisms ‘minimising language’ and ‘humour’. The theme ‘Orientation to agreement’ describes how professionals and patients seem to be oriented towards demonstrating agreement and mutual understanding. The last theme, ‘Offering information and options’, describes the professional formally giving factual information almost completely without verbal interaction between the professional and the patient.ConclusionThe results of this study show that the model of ASC can be enriched by adding minimising language and humour to the mechanisms that can be used to fulfil the psychological need ‘relatedness’. Second, our results show that professionals use only few mechanisms to meet the patients’ psychological needs ‘competence’ and ‘autonomy’. They mainly use information giving to meet patients’ need competence. To meet patients’ need for autonomy, the professionals keep all options open. This suggests that professionals could pay more attention to other mechanisms to meet patients’ needs for ‘competence’ and ‘autonomy’.

show abstract

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the SDT view, it is through the process of integration of these three psychological needs that a person comes to self-regulate (Kors et al, 2020). Autonomy support from healthcare providers includes not only providing information to the patient but also giving advice for health behaviour changes and meaningful relationships (Kors et al, 2020). In the current Korean medical environment where healthcare professionals encounter many patients in a limited amount of time, it can be challenging to sufficiently support all three psychological needs.…”

Section: Discussionmentioning

confidence: 99%

“…Unexpectedly, our study revealed that autonomy support from healthcare providers was not significantly associated with three primary psychological needs. In the SDT view, it is through the process of integration of these three psychological needs that a person comes to self‐regulate (Kors et al, 2020). Autonomy support from healthcare providers includes not only providing information to the patient but also giving advice for health behaviour changes and meaningful relationships (Kors et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with self‐management after hybrid revascularization in patients with peripheral artery disease: A structural equations model

Kim

Lee

Son

2022

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aim:To investigate the factors associated with self-management after hybrid revascularization in patients with lower extremity peripheral artery disease using a structural equation modelling approach. Design:A cross-sectional study was adopted.Methods: A total of 221 patients who underwent hybrid revascularization for peripheral artery disease of the lower limbs were included from outpatient clinics at a 1200-bed tertiary care hospital in Korea. Data were collected using a self-reported questionnaire between December 1, 2019, and August 31, 2020. Structural equation modelling was applied to test the hypothetical model. Results:The item mean score of participants' self-management was 6.28 (standard deviation, 0.83) out of 8. The structural equation modelling had a good fit index.Autonomy support from healthcare providers was directly associated with selfmanagement (β = 0.20, p = 0.041). Illness perception directly (β = −0.33, p = 0.031) and indirectly (β = −0.19, p = 0.032) influenced self-management through competence and relatedness in patients with peripheral artery disease. The construct of autonomy support from healthcare providers, illness perception, competence and relatedness accounted for 49% of the variance in self-management.The Sobel test confirmed the statistically significant mediating effects of competence (z = −4.52, p < 0.001) and relatedness (z = −2.12, p < 0.001) on the relationship between illness perception and self-management. Conclusion:Our findings revealed that autonomy support from healthcare providers and patients' illness perception directly influenced patients' self-management.Additionally, patients' illness perception can indirectly influence self-management through their perceived competence and relatedness.Impact: Healthcare providers' autonomy support to patients may promote self-care behaviours, leading to greater autonomous motivation. Assessment of patients' illness perception before patient education is vital to designing effective self-management strategies which can improve patients' perceived competency and meaningful relatedness with healthcare providers.

show abstract

Barriers and facilitators to providing autonomy supportive counselling to individuals seeking treatment for an eating disorder

et al. 2022

View full text Add to dashboard Cite

Factors influencing autonomy supportive consultation: A realist review

Cited by 13 publications

References 27 publications

Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction analysis

Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction analysis

Factors associated with self‐management after hybrid revascularization in patients with peripheral artery disease: A structural equations model

Barriers and facilitators to providing autonomy supportive counselling to individuals seeking treatment for an eating disorder

Contact Info

Product

Resources

About