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Factors influencing autonomy supportive consultation: A realist review
Joyce M Kors1, Emma Paternotte2, Linda Martin3
1Faculty of Medicine Vrije Universiteit Amsterdam, Research in Education, Amsterdam UMC, de Boelelaan1118 1081 HZ Amsterdam, the Netherlands; LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University, Van der Boechorststraat 1 1081 BT Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Van der Boechorststraat 7 1081 BT Amsterdam, the Netherlands.
Objective:
Gaining insight into contextual factors and mechanisms supporting or hindering autonomy supportive consultation and into outcomes of such consultations.
Methods:
We conducted a systematic review using the realist synthesis procedure according to RAMESES guideline. A search was performed in PubMed, Embase, PsycINFO and Cinahl from inception to March 2019 using the search terms: 'autonomy' AND 'support' AND 'consultation' OR 'communication' AND 'intervention'. The review process including paper selection, quality assessment, full text reading for data-extraction was conducted by two researchers independently.
Results:
Of 2792 articles, 18 met our inclusion criteria. Contextual factors influencing an autonomy supportive consultation were: work organization and the attitude of professionals. An overarching supporting mechanism for AS was relationship building. In addition, each phase of the decision-making process seems to need supporting mechanisms fulfilling patients 'specific psychological needs in that phase. The outcome of AS is higher levels of patient well-being.
Conclusion:
Autonomy supportive consultation works under various contexts coupled with mechanisms that give rise to favourable-outcomes, of which relationship building, taking time and exploring patients' needs seem the most important.
Practice Implications:
The results of our review facilitate professionals to reflect on their autonomy supportive consultation skills, which could improve their autonomy supportive behaviour.
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