Shared Decision-making between health care providers and patients at a Tertiary Hospital Diabetic Clinic in Tanzania

Abstract

Background Patients’ participation in decision making regarding their treatment is defined in ethical, legal and human rights standards in the provision of care that concerns health providers and the entire community. This study was conducted to document experiences of patients and health care providers on shared decision making. Methods:This study employed a phenomenological study design using in-depth interview technique. Study participants were diabetic patients visiting the clinic and healthcare providers working at Muhimbili National Hospital. Data was collected using the semi-structured interview guide with open-ended questions using an audio digital recorder. Content analysis method was used during analysis whereby categories were reached through the process of coding assisted by Nvivo 12 software. Results Participants in this study expressed the role of shared decision-making in the care of patients with diabetes, with report of engagement of patients by health care providers in making treatment decisions. Participants reported no use of decision-making aids; however, health education tools were reported by participants to be used for educating patients. Limited time, patient beliefs and literacy were documented as barriers of effective engagement of patients in decision making by their healthcare providers. Conclusion Engagement of patients in decision-making was noted in this study as experienced by participants of this study. Time, patient beliefs and patient literacy were documented as barriers for patients engagement, therefore diabetic clinic at Muhimbili National Hospital need to devise mechanisms for ensuring patients involvement in treatment decisions.

Does a postpartum “Green Star” family planning decision aid for adolescent mothers reduce decisional conflict? : A quasi-experimental study

“…A study on the experiences of diabetic patients and healthcare providers on shared decision-making conducted in Tanzania found that neither the patients nor the healthcare providers had been using decision-making aids; the patients reported that only health education tools are being used for educating them. [48]…”

A call to action for an inclusive model of shared decision‐making in healthcare

“…SDM has emerged as a policy issue in developed countries such as Canada, Australia, the UK, the USA, France, Germany, and Italy (Coulter, 2017). However, in developing countries, the implementation of SDM has faced challenges such as users’ health literacy, available time and resources, physician's communication style or attitude, and whether users are accustomed to taking a passive role (Kruk et al, 2018; Tong et al, 2017; Tong et al, 2020; Vedasto et al, 2021).…”

In Defense of Patient Autonomy in Kidney Failure Care When Treatment Choices Are Limited

“…Several practical factors may serve as barriers to respect for patient autonomy, particularly in resource-constrained environments, such as lack of training in facilitating shared decision making, poor communication skills, and limited clinician time. 56,58,59 Additional strategies may also be needed to address language barriers, low health literacy, or cultural norms that discourage conversations about death or end-of-life care. 58,59 Factors that generally impede access to health services for patients may limit their ability to engage with available opportunities for shared decision making or health education.…”

“…56,58,59 Additional strategies may also be needed to address language barriers, low health literacy, or cultural norms that discourage conversations about death or end-of-life care. 58,59 Factors that generally impede access to health services for patients may limit their ability to engage with available opportunities for shared decision making or health education.…”