Perceptions and experiences of older patients and healthcare professionals regarding shared decision-making in pulmonary rehabilitation: A qualitative study

Jiang, Yebin; Guo, Jianlan; Sun, Pingping; Chen, Zhongyi; Liu, Fenglan; Wang, Shanshan; Ding, Zhaosheng

doi:10.1177/02692155211010279

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…Still, due to the personal characteristics of the older women, this task was not easy. This is consistent with other studies that describe a perception of health personnel who also classify older people as stubborn and complicated in the attempt to include them in care processes [ 72 , 73 ]. All these moments, related to situations of AL, SDM and participation in care, were plagued with anomalies that did not allow older women to take an active agency role in their care, nor did primary care nurses establish therapeutic communication with them.…”

Section: Discussionsupporting

confidence: 91%

Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective

Martínez-Angulo,

Rich-Ruiz,

Jiménez-Mérida

et al. 2024

BMC Nurs

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Background Nursing care for older women represent a challenge worldwide due to its characteristics. When communication is impaired between primary care nurses and older women living alone, an imbalance in power relations occurs. The main objective of this study is to analyse the power relations between older women and primary care nurses in situations of active listening, shared decision-making and participation in care. Methods We developed a qualitative study in southern Spain using a discursive and gender approach. We used purposeful sampling to interview older women who lived alone and received home nursing care. Simultaneously, we conducted focus groups with primary care nurses who provided home care to older women. A linguistic analysis of the transcripts was carried out. Results Nine semi-structured face-to-face interviews were conducted with older women who lived alone and two face-to-face focus groups with four primary care nurses in each. The discourse of the participants demonstrated an imbalance in power relations. Influenced by work overload, active listening was considered a privilege in primary care nurses´ discourse. Regarding shared decision-making, older women´s discourses revealed “mirages” of real situations where they thought they were deciding. Participation in care was difficult since older women saw themselves as a nuisance in nurses´ presence, and primary care nurses did not facilitate older women’s engagement. Older women weren´t considered when organising home visits and had interiorised a subordinated feeling. Similarly, a strict sense of identity made primary care nurses feel powerful in their relationships with older women. Conclusions The discourse of older women represented them as victims of a hostile panorama whilst they were sometimes satisfied with the deficient care received. The discourse of primary care nurses used more discursive strategies to represent themselves as professionals committed to caring. However, it also revealed deficiencies in care, discriminatory elements, and feelings of being limited by their working conditions. Active listening to older women and engagement in decision-making readjust empower the older women. Attending to the needs and concerns of primary care nurses could recalibrate the power imbalance between them and healthcare organisations.

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Section: Discussionsupporting

confidence: 91%

Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective

Martínez-Angulo,

Rich-Ruiz,

Jiménez-Mérida

et al. 2024

BMC Nurs

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“…13 Shared decision-making promotes patient involvement in clinical decision-making in partnership with health professionals. 17 Shared decision-making can be used in the development, design and implementation of healthcare interventions by creating tailored treatment programmes and patient-centred goals according to patients' preferences. 18 Rehabilitation aims to enable people to optimise their mobility, capability, autonomy, function and quality of life.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…It also relates to the connections that patients have with health professionals,16 and the degree to which patients participate in the design and delivery of health initiatives 13. Shared decision-making promotes patient involvement in clinical decision-making in partnership with health professionals 17. Shared decision-making can be used in the development, design and implementation of healthcare interventions by creating tailored treatment programmes and patient-centred goals according to patients’ preferences 18…”

Section: Introductionmentioning

confidence: 99%

Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review

et al. 2022

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BackgroundCodesign strengthens partnerships between healthcare workers and patients. It also facilitates collaborations supporting the development, design and delivery of healthcare services. Prior rehabilitation reviews have focused mainly on the clinical and organisational outcomes of codesign with less focus on the lived experience of rehabilitation patients.ObjectiveTo explore patient experiences of codesigned hospital rehabilitation interventions.DesignRapid review and evidence synthesis of the literature.Data sourcesCINAHL, MEDLINE, Embase and Cochrane were searched from 1 January 2000 to 25 April 2022.Study selectionStudies reporting patient experiences of codesigned rehabilitation interventions in hospitals.Results4156 studies were screened, and 38 full-text studies were assessed for eligibility. Seven studies were included in the final rapid review. Five out of the seven studies involved neurological rehabilitation. All eligible studies used qualitative research methods. The main barriers to codesign were related to staffing and dedicated time allocated to face-to-face patient-therapist interactions. High-quality relationships between patients and their therapists were a facilitator of codesign. Thematic synthesis revealed that codesigned rehabilitation interventions can enable a meaningful experience for patients and facilitate tailoring of treatments to align with individual needs. Personalised rehabilitation increases patient involvement in rehabilitation planning, delivery and decision-making. It also promotes positive feelings of empowerment and hope.ConclusionThis rapid review supports the implementation of codesigned rehabilitation interventions to improve patient experiences in hospitals.PROSPERO registration numberCRD42021264547.

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“… 11 , 12 Studies pointed to the need to integrate SDM into pulmonary rehabilitation services. 13 , 14 However, little research has been found on the application of SDM in pulmonary rehabilitation and no decision aids for pulmonary rehabilitation have been developed.…”

Section: Introductionmentioning

confidence: 99%

Development of a Pulmonary Rehabilitation Patient Decision Aid for Patients with Chronic Obstructive Pulmonary Disease: Mixed Methods Study

Jiang¹,

Guo²,

Chen³

et al. 2023

COPD

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Background: Pulmonary rehabilitation is an important part of the management of chronic obstructive pulmonary disease (COPD), but the participation rate of pulmonary rehabilitation in COPD patients is low. Patient decision aids can facilitate patient participation in pulmonary rehabilitation decisions by providing information and incorporating patient values. The aim of this study was to develop a pulmonary rehabilitation decision aid for patients with COPD. Objective: The aim of this study was to develop a WeChat-based pulmonary rehabilitation patient decision aid to help older patients with COPD participate in pulmonary rehabilitation decision-making. Methods: We developed the decision aid in 3 stages: (1) a literature review was performed to determine the evidence for pulmonary rehabilitation options and outcomes for patients with COPD. (2) a semi-structured interview study was conducted to develop and iterate patient decision aids. (3) usability, acceptability and language expression testing in patients and healthcare professionals. Results: A total of 16 randomized controlled studies were included in the literature review. Thirty-six participants received semistructured interviews. The results of interview include four themes: key points of age-friendly design, content of the tool, presentation requirements of contents and study evidence of the tool and other views and suggestions. The resultant goals-of-care decision aid achieved good usability and acceptability. The frequency of language expression increased in both patients and healthcare professionals. Conclusion:This study uses a systematic development process to develop the first pulmonary rehabilitation decision aid for patients with COPD. It has good usability, acceptability and increased communication between patients and healthcare professionals in the pulmonary rehabilitation decision-making process. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900028563; http://apps.who.int/trialsearch/default.aspx.

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Perceptions and experiences of older patients and healthcare professionals regarding shared decision-making in pulmonary rehabilitation: A qualitative study

Cited by 5 publications

References 29 publications

Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective

Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective

Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review

Development of a Pulmonary Rehabilitation Patient Decision Aid for Patients with Chronic Obstructive Pulmonary Disease: Mixed Methods Study

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