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What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment.
Acta Oncol. 2016 Dec; 55(12):1484-1491.AO

Abstract

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+Show Affiliations

a Department of Medical Psychology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.a Department of Medical Psychology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.a Department of Medical Psychology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27607314

Citation

Müller, Evamaria, et al. "What Do Stakeholders Need to Implement Shared Decision Making in Routine Cancer Care? a Qualitative Needs Assessment." Acta Oncologica (Stockholm, Sweden), vol. 55, no. 12, 2016, pp. 1484-1491.
Müller E, Hahlweg P, Scholl I. What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment. Acta Oncol. 2016;55(12):1484-1491.
Müller, E., Hahlweg, P., & Scholl, I. (2016). What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment. Acta Oncologica (Stockholm, Sweden), 55(12), 1484-1491.
Müller E, Hahlweg P, Scholl I. What Do Stakeholders Need to Implement Shared Decision Making in Routine Cancer Care? a Qualitative Needs Assessment. Acta Oncol. 2016;55(12):1484-1491. PubMed PMID: 27607314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment. AU - Müller,Evamaria, AU - Hahlweg,Pola, AU - Scholl,Isabelle, Y1 - 2016/09/08/ PY - 2016/9/9/pubmed PY - 2017/1/18/medline PY - 2016/9/9/entrez SP - 1484 EP - 1491 JF - Acta oncologica (Stockholm, Sweden) JO - Acta Oncol VL - 55 IS - 12 N2 - 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. SN - 1651-226X UR - https://www.unboundmedicine.com/medline/citation/27607314/What_do_stakeholders_need_to_implement_shared_decision_making_in_routine_cancer_care_A_qualitative_needs_assessment_ L2 - https://www.tandfonline.com/doi/full/10.1080/0284186X.2016.1227087 DB - PRIME DP - Unbound Medicine ER -