The impact of <scp>DECISION</scp>+2 on patient intention to engage in shared decision making: secondary analysis of a multicentre clustered randomized trial

Couët, Nicolas; Labrecque, Michel; Robitaille, Hubert; Turcotte, Stéphane

doi:10.1111/hex.12235

Cited by 14 publications

(16 citation statements)

References 34 publications

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“…The remaining program were delivered to health professionals providing care to people with chronic or complex health problems [45], within pediatrics [44], diabetes care [46], medical rehabilitation [57] and intensive care [55]. Of the 10 SDM programs in primary care, eight were for primary care physicians only [11,24,[58][59][60][61][62][63][64][65][66][67][68][69], one for primary care nurses [70] and one for both primary care physicians and nurses [23]. Of the eight programs for students, all were for medical students or residents [1,[71][72][73][74][75][76][77].…”

Section: Target Audience/clinical Specialtymentioning

confidence: 99%

“…Eight programs were delivered in a single face-to-face group session [1, 47, 51, 71-73, 76, 77], ten programs were delivered across multiple days [22, 29, 31, 33, 43, 45, 48, 52, 54-57, 63, 64, 75, 79], seven consisted of face-to-face group training as well as individual mentoring/reminders [24,27,35,53,58,59,65,70,78,81], seven were delivered online [23,44,46,62,[67][68][69], one consisted of a face-to-face and online component [74], one of a face-to-face and online component as well as reminders post training [11,60,61], one consisted of individual in situ training delivered at the clinician's place of work [50,80], and was a combination of in-situ and online training [66]. The structure of one training program was not clearly described [49].…”

Section: Training Structure Duration and Deliverymentioning

confidence: 99%

“…SDM is the philosophy and process of involving patients in decisions about their own care informed by clinical evidence and patient values and preferences [6,8,9]. SDM is especially relevant or important when health problems have multiple appropriate treatment options, where there is a close trade-off between harms and benefits or when the evidence is not clear [10][11][12][13][14]. In such situations, clinicians may know more about the risks and benefits of each course of action, but patients know more about their own preferences and values in relation to these consequences [11].…”

Section: Introductionmentioning

confidence: 99%

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Training Interventions to Equip Health Care Professionals With Shared Decision-Making Skills: A Systematic Scoping Review

Coates

Teena

2020

J Contin Educ Health Prof

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Despite numerous initiatives to increase SDM worldwide, SDM has not yet been widely implemented in clinical practice. A key barrier to SDM is that many health professionals have not been trained with the relational and communication skills required for SDM. To support the development and implementation of SDM training programs, this paper maps the evidence in relation to SDM training programs for health professionals and students, in terms of training design and content as well as evaluation outcomes. Method:Using a systematic scoping review methodology, quantitative and qualitative evidence were systematically considered to map the literature in relation to SDM training. To identify studies, the databases PubMed, Medline and CINAHL were searched from 2009 to 2019 and reference lists of included studies were examined. Articles were reviewed for inclusion by both authors, and data was extracted using a purposely designed form. Results:The review identified 49 studies evaluating 36 unique training programs, of which 18 were for health professionals in tertiary settings, 10 in primary care and 8 for students. Most programs were evaluated descriptively, mostly using mixed methods, and there were 18 RCTs. There was considerable variation in terms of the design and duration of programs. Most programs included an overview of SDM theories and key competencies, and included SDM skill development through role plays. Few or no programs provided training in reflective practice, in identifying and working with patients' individually preferred decision-making style, or in relation to SDM in a context of medical uncertainty or ambiguity. Overall training was feasible, well received, and improved participants' knowledge and skills, but limited in its impact on patients. Conclusion:While given the diversity in training programs and evaluation methods used this review is limited in its ability to comment on which types of training programs are more effective than others, there remains a need for longer-term and more in-depth training to embed SDM in practice. Eligibility criteria As per Table 1, studies relevant to the implementation and effectiveness and of training interventions were included (see Table 1).Insert Table 1: Inclusion and Exclusion.Table 1: Inclusion and exclusion criteria Inclusion criteria Exclusion criteria Studies about the implementation and/or evaluation of SDM training for health professionals and/or students/trainees/residents, including interventions in the use of decision aids Studies about SDM training for patients only, or the implementation of SDM without a specific training program Studies in relation communication training programs that include SDM as a core component Studies in relation to communication training more broadly, without a SDM component Primary qualitative, quantitative (descriptive and analytic) and mixed method studies Literature reviews, opinion pieces Published in peer reviewed journals Non-peer reviewed studies, conference papers and study protocols Published between 2009 and March...

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Section: Target Audience/clinical Specialtymentioning

confidence: 99%

Section: Training Structure Duration and Deliverymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Training Interventions to Equip Health Care Professionals With Shared Decision-Making Skills: A Systematic Scoping Review

Coates

Teena

2020

J Contin Educ Health Prof

View full text Add to dashboard Cite

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“…Sample size estimates were derived based on the primary outcome of intention score, with the estimates of effect based on previously published values31 and refined considering pilot data. For each stratified analysis arm (ie, inadequate health literacy, adequate health literacy), a sample of n=162 subjects per intervention group is expected to provide approximately 80% power to detect a small main effect (effect size of 0.10 or greater) of the Choosing Wisely Australia 5 Questions resource; and over 80% power to detect small main effects (effect sizes 0.20 or larger) of the preparation video intervention, and their interaction, at a p-value of 0.05 in primary analyses.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the Choosing Wisely Australia 5 Questions resource and a shared decision-making preparation video: protocol for an online experiment

et al. 2019

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IntroductionChoosing Wisely, an international effort to reduce low value care worldwide, considers communication between clinicians and patients during routine clinical encounters a key mechanism for change. In Australia, Choosing Wisely has developed a 5 Questions resource to facilitate better conversations. The primary aim of this study is to evaluate the impact of the Choosing Wisely Australia 5 Questions resource and a video designed to prepare patients for question-asking and participation in shared decision-making on (a) self-efficacy to ask questions and participate in shared decision-making, (b) intention to participate in shared decision-making and (c) a range of secondary outcomes. The secondary aim of this study is to determine whether participants’ health literacy modifies the effects of the interventions.Methods and analysisWe will use 2×2×2 between-subjects factorial design (preparation video: yes, no × Choosing Wisely 5 Questions resource: yes, no × health literacy: adequate, inadequate). Participants will be recruited by an online market research company, presented with a hypothetical non-specific low back pain scenario, and randomised to study groups stratified by health literacy. Quantitative primary and secondary outcome data will be analysed as intention-to-treat using appropriate regression models (ie, linear regression for continuous outcomes, logistic regression for dichotomous categorical outcomes).Ethics and disseminationEthical approval for this study was obtained from the University of Sydney Human Research Ethics Committee (protocol number: 2018/965). The results from this work will be disseminated through peer-reviewed international journals, conferences and updates with collaborating public health bodies. Resources developed for this study will be made available to patients and clinicians following trial completion.Trial registration numberThis trial has been registered with the Australia New Zealand Clinical Trials Registry (trial number: 376477) and the stage is Pre-results.

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“…Higher education has been reported having a positive correlation with higher clinician’s level of participation. 18 To measure the level of participation among nurses, a separate valid and reliable instrument must be developed for this specific construct on level of participation. Testing of hypothesized correlations of education with SDM-N competency score and the level of participation in SDM among nurses must be conducted in future studies to test any positive or negative associations of these variables.…”

Section: Scoringmentioning

confidence: 99%

Role competency scale on shared decision-making nurses: Development and psychometric properties

et al. 2018

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Objectives:This study aimed to develop a scale that can measure the role competency of oncology nurses during shared decision-making process.Methods:A total of 226 oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest completed the online or mail survey. Exploratory factor analysis and parallel analysis showed the multidimensionality of the role competency scale on shared decision-making nurses.Results:The role competency scale on shared decision-making nurses revealed four dimensions: knowledge, attitudes, communication, and adaptability. The 22 items have excellent internal consistency with a Cronbach’s alpha of 0.91. The four subscales also have adequate reliability with Cronbach’s alpha >0.70 as well as greater than 0.70 Spearman–Brown’s correlation coefficients in split-half reliability testing for each subscale.Conclusion:The new scale has the potential to be used as a clinical tool to assess the need for shared decision-making education and training in oncology nurses.

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The impact of DECISION+2 on patient intention to engage in shared decision making: secondary analysis of a multicentre clustered randomized trial

Abstract: Background Training health professionals in shared decision making (SDM) may influence their patients' intention to engage in SDM.

Cited by 14 publications

References 34 publications

Training Interventions to Equip Health Care Professionals With Shared Decision-Making Skills: A Systematic Scoping Review

Training Interventions to Equip Health Care Professionals With Shared Decision-Making Skills: A Systematic Scoping Review

Evaluation of the Choosing Wisely Australia 5 Questions resource and a shared decision-making preparation video: protocol for an online experiment

Role competency scale on shared decision-making nurses: Development and psychometric properties

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