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Development of a program theory for shared decision-making: a realist review protocol.

Gary Groot1, Tamara Waldron2, Tracey Carr2

  • 1Department of Community Health and Epidemiology, Health Sciences Building, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada. gary.groot@usask.ca.

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Summary

This realist review explores how shared decision-making (SDM) between patients and healthcare providers improves health outcomes. It identifies contextual factors influencing SDM

Keywords:
Health systemsMechanismsMedical decision-makingQuality improvementRealist reviewShared decision-making

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Area of Science:

  • Health Services Research
  • Evidence-Based Practice
  • Patient-Centered Care

Background:

  • Implementing evidence-based practices in healthcare systems faces challenges.
  • Shared decision-making (SDM) aims to improve patient and system outcomes by fostering collaboration.
  • Gaps exist between SDM theory and real-world implementation.

Purpose of the Study:

  • To explore the contextual factors influencing the effectiveness of SDM.
  • To understand in which situations, how, why, and for whom SDM contributes to improved decision-making.

Main Methods:

  • A realist review protocol will be employed.
  • A seven-step iterative process includes theory development, literature search, appraisal, data extraction, and synthesis.
  • Stakeholder input from patients, providers, and policymakers will refine the program theory.

Main Results:

  • The review aims to identify and refine a program theory for SDM.
  • Mechanisms influencing the success or failure of SDM will be identified.
  • Understanding contextual influences on SDM effectiveness is the primary goal.

Conclusions:

  • This study will advance the understanding of SDM implementation in healthcare.
  • Refining SDM program theory can guide effective practice and policy.
  • Identifying contextual factors is crucial for successful SDM integration.