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Published on: February 16, 2011
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Exploring motivations and resistances for implementing shared decision-making in clinical practice: A systematic
Changhai Tang1, Anqi Wang1, Jingjing Yan2,3
1School of Public Health, Weifang Medical University, Weifang, Shandong, China.
Summary
Implementing shared decision-making (SDM) in patient care faces structural challenges. Addressing these requires understanding the interplay of factors to improve healthcare systems and patient outcomes.
Area of Science:
- Health Services Research
- Patient-Centered Care
- Clinical Practice Improvement
Background:
- Shared decision-making (SDM) is crucial for patient-centered care but faces limited clinical implementation.
- Understanding barriers and facilitators is key to advancing SDM in practice.
Purpose of the Study:
- To synthesize motivations and resistances influencing SDM implementation.
- To investigate the relationships between these factors for practical advancement.
Main Methods:
- Systematic review of literature from 2000-2021 using PubMed, Web of Science, and EBSCO.
- Quality appraisal using the QualSyst Tool and content analysis based on the 'structure-process-outcome' model.
Main Results:
- 105 studies (53 qualitative, 52 quantitative) identified 42 factors across structure, process, and outcome dimensions.
- Key factors include decision-making time, patient preparedness, physician communication, and healthcare environment.
- Chronic and unspecified diseases showed more influencing factors for SDM implementation.
Conclusions:
- Structural factors present significant challenges to SDM implementation globally.
- Further research on factor interactions is needed for integrated strategies to enhance SDM effectiveness.
Keywords:
motivationpatient-centred careresistanceshared decision-makingstructure-process-outcome modelMore Related Videos
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