Prediction of health professionals' intention to screen for decisional conflict in clinical practice

Graham, Ian D.; O’Connor, Annette; Aubin, Michèle; Baillargeon, Lucie; Leduc, Yvan; Maziade, Jean

doi:10.1111/j.1369-7625.2007.00465.x

Cited by 38 publications

(20 citation statements)

References 52 publications

(108 reference statements)

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“…This factor is most often associated with the intention among health professionals [15]. Also, a study based on the TPB that also explored other SDM–related behaviours among healthcare professionals revealed that this factor was the most significant predictor of the intention [38]. With regard to individual control beliefs, lack of time and lack of interviewing skills were those common to both behaviours in significantly explaining intention.…”

Section: Discussionmentioning

confidence: 92%

Psychosocial Factors of Dietitians' Intentions to Adopt Shared Decision Making Behaviours: A Cross-Sectional Survey

et al. 2013

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ObjectivesWhile shared decision making (SDM) promotes health-related decisions that are informed, value-based and adhered to, few studies report on theory-based approaches to SDM adoption by healthcare professionals. We aimed to identify the factors influencing dietitians' intentions to adopt two SDM behaviours: 1) present dietary treatment options to patients and 2) help patients clarify their values and preferences.MethodsWe conducted a cross-sectional postal survey based on the Theory of Planned Behaviour among 428 randomly selected dietitians working in clinical practice across the Province of Quebec, Canada. We performed descriptive analyses and multiple regression analyses to determine the variables that explained the variance in intention to perform the behaviours.ResultsA total of 203 dietitians completed the questionnaire. Their ages were from 23 to 66 and they had been practising dietetics for 15.4±11.1 years (mean ± SD). On a scale from 1 to 7 (from strongly disagree to strongly agree), dietitians' intentions to present dietary treatment options and to clarify their patients' values and preferences were 5.00±1.14 and 5.68±0.74, respectively. Perceived behavioural control (β = 0.56, ρ<0.0001), subjective norm (β = 0.16, ρ<0.05), and moral norm (β = 0.22, ρ<0.0001), were the factors significantly predicting the intention to present dietary treatment options, while perceived behavioural control (β = 0.60, ρ<0.0001), attitude (β = 0.20, ρ<0.05), and professional norm (β = 0.22, ρ<0.001), significantly predicted the intention to help patients' clarify their values and preferences.ConclusionOur results showed that dietitians intend to adopt the two SDM behaviours studied. Factors influencing intention were different for each behaviour, except for perceived behavioural control which was common to both behaviours. Thus, perceived behavioural control could be a key factor in interventions aiming to encourage implementation of SDM by dietitians.

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Section: Discussionmentioning

confidence: 92%

Psychosocial Factors of Dietitians' Intentions to Adopt Shared Decision Making Behaviours: A Cross-Sectional Survey

et al. 2013

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“…Accordingly, decisional conflict screening matches patients' needs to the level of decision support required. Evidence suggests that the intention of primary care practitioners ( n = 122) to involve patients in decision making is strengthened following an intervention that involved a workshop on shared decision making and the use of the decisional conflict scale as a clinical screening tool (Légaré 2007; Légaré et al 2006a). Other factors influencing practitioners' role in engaging patients to participate in decision making included their attitudes about shared decision making, perceived control over their behaviors, shared decision making practices of others within their practice environment, and involvement in continuing education.…”

mentioning

confidence: 99%

Decision Coaching to Support Shared Decision Making: A Framework, Evidence, and Implications for Nursing Practice, Education, and Policy

Stacey

Murray²,

Légaré

et al. 2008

Worldviews Ev Based Nurs

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Enhancing nurses' coaching skills for supporting patients and their families in decision making can be fostered through interventions aimed at the nurses, educational systems, and regulatory organizations. Further research and pragmatic evaluation are needed to better support the acquisition and implementation of decision coaching for all types of health decisions. APPLICATION TO NURSING PRACTICE: The framework indicates the practitioner's role in diagnosing the problem, providing options, and screening for decisional conflict. Decision coaching involves assessing factors influencing patients' decisional conflict, providing support to address decisional needs, monitoring progress in decision making, and screening for factors influencing implementation. Informed patients share their values and preferences shaped by their personal situation.

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“…Designed on the basis of previous exploratory work, 29,31–33 DECISION+ is a theory‐based, continuing professional development program made up of three main components: (i) interactive workshops and related material; (ii) reminders of expected behaviours; and (iii) feedback to FPs on the agreement between their decisional conflict and that of their patients 25 …”

Section: Methodsmentioning

confidence: 99%

Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial

Labrecque

LeBlanc

Njoya

et al. 2011

Health Expectations

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BackgroundExperts estimate that the prevalence of antibiotics use exceeds the prevalence of bacterial acute respiratory infections (ARIs).ObjectiveTo develop, adapt and validate DECISION+ and estimate its impact on the decision of family physicians (FPs) and their patients on whether to use antibiotics for ARIs.DesignTwo-arm parallel clustered pilot randomized controlled trial.Setting and participantsFour family medicine groups were randomized to immediate DECISION+ participation (the experimental group) or delayed DECISION+ participation (the control group). Thirty-three FPs and 459 patients participated.InterventionDECISION+ is a multiple-component, continuing professional development program in shared decision making that addresses the use of antibiotics for ARIs.Main outcome measuresThroughout the pilot trial, DECISION+ was adapted in response to participant feedback. After the consultation, patients and FPs independently self-reported the decision (immediate use, delayed use, or no use of antibiotics) and its quality. Agreement between their decisional conflict was assessed. Two weeks later, patients assessed their decisional regret and health status.ResultsCompared to the control group, the experimental group reduced its immediate use of antibiotics (49 vs. 33% absolute difference = 16%; P = 0.08). Decisional conflict agreement was stronger in the experimental group (absolute difference of Pearson's r = 0.26; P = 0.06). Decisional regret and perceptions of the quality of the decision and of health status in the two groups were similar.Discussion and conclusionsDECISION+ was developed successfully and appears to reduce the use of antibiotics for ARIs without affecting patients' outcomes. A larger trial is needed to confirm this observation.

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Prediction of health professionals' intention to screen for decisional conflict in clinical practice

Cited by 38 publications

References 52 publications

Psychosocial Factors of Dietitians' Intentions to Adopt Shared Decision Making Behaviours: A Cross-Sectional Survey

Psychosocial Factors of Dietitians' Intentions to Adopt Shared Decision Making Behaviours: A Cross-Sectional Survey

Decision Coaching to Support Shared Decision Making: A Framework, Evidence, and Implications for Nursing Practice, Education, and Policy

Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial

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