BACKGROUND: Shared decision making (SDM) is particularly relevant in oncology, where complex treatment options with varying side effects may lead to meaningful changes in the patient's quality of life. For several years, health policies have called for the implementation of SDM, but SDM remains poorly implemented in routine clinical practice. Implementation science has highlighted the importance of assessing stakeholders' needs to inform the development of implementation programs. Thus, the aim of the present study was to assess different stakeholders' needs regarding the implementation of SDM in routine care. MATERIAL AND METHODS: A qualitative study using focus groups and interviews was conducted. Focus groups were carried out with junior physicians, senior physicians, nurses and other healthcare providers (HPCs) (e.g. psycho-oncologists, physiotherapists), patients and family members. Head physicians as well as other HPCs in management positions were interviewed. Audiotapes of focus groups and interviews were transcribed verbatim and analyzed using content analysis. RESULTS: Six focus groups with a total of n = 42 stakeholders as well as n = 17 interviews were conducted. Focus groups and interviews revealed five main categories of needs to be fulfilled in order to achieve a better implementation of SDM in routine cancer care: 1) changes in communication, 2) involvement of other parties, 3) a trustful patient-physician relationship, 4) culture change and 5) structural changes. Stakeholders discussed four clusters of intervention strategies that could foster the implementation of SDM in routine cancer care: 1) clinician-mediated interventions, 2) patient-mediated interventions, 3) provision of patient information material and 4) the establishment of a patient advocate. CONCLUSION: Study results show that stakeholders voiced a diversity of needs to foster implementation of SDM in routine cancer care, of which some can be directly addressed by intervention strategies. Present results can be used to develop an implementation program to foster SDM in routine cancer care.
BACKGROUND: Shared decision making (SDM) is particularly relevant in oncology, where complex treatment options with varying side effects may lead to meaningful changes in the patient's quality of life. For several years, health policies have called for the implementation of SDM, but SDM remains poorly implemented in routine clinical practice. Implementation science has highlighted the importance of assessing stakeholders' needs to inform the development of implementation programs. Thus, the aim of the present study was to assess different stakeholders' needs regarding the implementation of SDM in routine care. MATERIAL AND METHODS: A qualitative study using focus groups and interviews was conducted. Focus groups were carried out with junior physicians, senior physicians, nurses and other healthcare providers (HPCs) (e.g. psycho-oncologists, physiotherapists), patients and family members. Head physicians as well as other HPCs in management positions were interviewed. Audiotapes of focus groups and interviews were transcribed verbatim and analyzed using content analysis. RESULTS: Six focus groups with a total of n = 42 stakeholders as well as n = 17 interviews were conducted. Focus groups and interviews revealed five main categories of needs to be fulfilled in order to achieve a better implementation of SDM in routine cancer care: 1) changes in communication, 2) involvement of other parties, 3) a trustful patient-physician relationship, 4) culture change and 5) structural changes. Stakeholders discussed four clusters of intervention strategies that could foster the implementation of SDM in routine cancer care: 1) clinician-mediated interventions, 2) patient-mediated interventions, 3) provision of patient information material and 4) the establishment of a patient advocate. CONCLUSION: Study results show that stakeholders voiced a diversity of needs to foster implementation of SDM in routine cancer care, of which some can be directly addressed by intervention strategies. Present results can be used to develop an implementation program to foster SDM in routine cancer care.
Authors: Alessandro Bottacini; Claudia Goss; Maria Angela Mazzi; Alberto Ghilardi; Chiara Buizza; Annamaria Molino; Elena Fiorio; Rolando Nortilli; Vito Amoroso; Lucia Vassalli; Richard F Brown Journal: BMJ Open Date: 2017-08-11 Impact factor: 2.692
Authors: David Benjamin Lumenta; Gerald Sendlhofer; Gudrun Pregartner; Marlies Hart; Peter Tiefenbacher; Lars Peter Kamolz; Gernot Brunner Journal: PLoS One Date: 2019-02-15 Impact factor: 3.240
Authors: Marieke M T Kuijpers; Haske van Veenendaal; Vivian Engelen; Ella Visserman; Eveline A Noteboom; Anne M Stiggelbout; Anne M May; Niek de Wit; Elsken van der Wall; Charles W Helsper Journal: Eur J Cancer Care (Engl) Date: 2021-11-02 Impact factor: 2.328
Authors: Sara Shaw; Gemma Hughes; Tim Stephens; Rupert Pearse; John Prowle; Richard Edmund Ashcroft; Ester Avagliano; James Day; Mark Edsell; Jennifer Edwards; Leslie Everest Journal: BMJ Open Date: 2020-05-05 Impact factor: 2.692