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Barriers and facilitators to implement shared decision making in multidisciplinary sciatica care: a qualitative

Stefanie N Hofstede1, Perla J Marang-van de Mheen, Manon M Wentink

  • 1Department of Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, ZA, The Netherlands. l.vanbodegom-vos@lumc.nl.

Implementation Science : IS
|August 24, 2013
PubMed
Summary
This summary is machine-generated.

Implementing shared decision making (SDM) in multidisciplinary sciatica care faces more barriers than facilitators. New challenges arise from the team-based approach, requiring targeted strategies for successful integration.

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Area of Science:

  • Healthcare Management
  • Patient-Centered Care
  • Clinical Guideline Implementation

Background:

  • The Dutch guideline for sciatica advocates for shared decision making (SDM) between patients and multidisciplinary care teams.
  • Despite recommendations, SDM is not consistently integrated into sciatica care.
  • Existing research on SDM barriers often overlooks the complexities of multidisciplinary settings.

Purpose of the Study:

  • To identify barriers and facilitators to SDM implementation in multidisciplinary sciatica care from both patient and professional perspectives.
  • To address the gap in understanding SDM challenges within a team-based healthcare environment.

Main Methods:

  • Conducted 40 semi-structured interviews with various sciatica care professionals.
  • Held three focus groups with patients (6-8 participants each).
  • Analyzed qualitative data using the Grol and Wensing framework and Atlas.ti 7.0 software.

Main Results:

  • Professionals reported 53 barriers and 5 facilitators; patients reported 35 barriers and 18 facilitators.
  • Professionals identified most barriers in the organizational context, while patients focused on individual professional levels.
  • New barriers identified by both groups related to the multidisciplinary setting, including lack of visibility, trust, and interdisciplinary communication.

Conclusions:

  • This study highlights significant barriers and facilitators for SDM in multidisciplinary sciatica care.
  • More barriers than facilitators were identified, emphasizing the need for focused implementation strategies.
  • Addressing newly identified barriers specific to the multidisciplinary setting is crucial for effective SDM integration in sciatica care.