Article Text
Abstract
Objectives To explore physicians’ and nurses’ knowledge, attitudes and experiences of shared decision making (SDM) in rheumatology, to identify barriers and facilitators to SDM, and to examine whether physicians’ and nurses’ perspectives of SDM differ.
Methods A cross-sectional, exploratory, online survey was used. Besides demographic characteristics, healthcare professionals’ knowledge, attitudes and experiences of SDM in rheumatology were assessed. Barriers and facilitators to SDM were identified from healthcare professionals’ answers. Descriptive statistics were computed and differences between physicians’ and nurses’ perspectives of SDM were examined with a t-test or Fisher’s exact test, as appropriate.
Results Between April and June 2019, 77 physicians and 70 nurses completed the survey. Although most healthcare professionals lacked a full conceptual understanding of SDM, almost all physicians (92%) and all nurses had a (very) positive attitude toward SDM, which was most frequently motivated by the belief that SDM improves patients’ treatment adherence. The majority (>50%) of healthcare professionals experienced problems with the application of SDM in clinical practice, mostly related to time constraints. Other important barriers were the incompatibility of SDM with clinical practice guidelines and beliefs that patients do not prefer to be involved in decision making or are not able to take an active role. Modest differences between physicians’ and nurses’ perspectives of SDM were found.
Conclusions There is a clear need for education and training that equips and empowers healthcare professionals to apply SDM. Furthermore, the commitment of time, resources and financial support for national, regional and organisational initiatives is needed to make SDM in rheumatology a practical reality.
- nursing
- qualitative research
- treatment
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Footnotes
Contributors EGEM: study conception and design, collection of data, analysis and interpretation of data, drafting and critical revision of the manuscript, and approval of the final version of the manuscript. BvdB: study conception and design, critical revision of the manuscript, and approval of the final version of the manuscript. SW: study conception and design, critical revision of the manuscript, and approval of the final version of the manuscript. FvdH: study conception and design, critical revision of the manuscript, and approval of the final version of the manuscript. JEV: study conception and design, analysis and interpretation of data, critical revision of the manuscript, and approval of the final version of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not applicable.
Ethics approval The Dutch medical research ethical committee of Arnhem-Nijmegen waived ethical approval since this study was not subject to the medical research involving human subjects act (file number 2019–5315).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.