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Tytuł:
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Facilitators and barriers to implementing shared decision making: A cross-sectional study of physicians in Japan.
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Autorzy:
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Koyama T; Professional Development Center, Tokyo Medical and Dental University, Tokyo, Japan.
Nawa N; Professional Development Center, Tokyo Medical and Dental University, Tokyo, Japan; Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan.
Itsui Y; Professional Development Center, Tokyo Medical and Dental University, Tokyo, Japan.
Okada E; Professional Development Center, Tokyo Medical and Dental University, Tokyo, Japan; Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan.
Fujiwara T; Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: .
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Źródło:
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Patient education and counseling [Patient Educ Couns] 2022 Jul; Vol. 105 (7), pp. 2546-2556. Date of Electronic Publication: 2022 Jan 31.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Limerick : Elsevier
Original Publication: Princeton, N.J. : Excerpta Medica, c1983-
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MeSH Terms:
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Decision Making, Shared*
Physicians*
Cross-Sectional Studies ; Decision Making ; Humans ; Japan ; Patient Participation
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Contributed Indexing:
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Keywords: Integrated Behavioral Model; Japan; Shared decision making
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Entry Date(s):
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Date Created: 20220221 Date Completed: 20220616 Latest Revision: 20220803
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Update Code:
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20240105
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DOI:
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10.1016/j.pec.2022.01.016
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PMID:
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35184910
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Objective: Shared decision making (SDM) is a collaborative process in which patients and healthcare providers jointly make a medical decision. This cross-sectional study aimed to identify the facilitators and barriers to self-reported implementation of SDM in Japan, and to explore if there is effect modification by hospital types.
Methods: A total of 129 physicians in Japan completed a questionnaire that asked about their perception of SDM based on SDM-Q-Doc and its facilitators and barriers, which corresponded to each construct of the integrated behavioral model (IBM). The association between facilitators and barriers and SDM-Q-doc score was assessed using linear regression analysis. Stratified analysis by hospital types was also performed.
Results: Significant facilitators included physicians' attitude, injunctive norm, intention and habit. Significant barriers included physicians' unfavorable attitude, lack of self-efficacy, knowledge, salience and experience. Moreover, experiential attitude (concerning patient characteristics), injunctive norm (concerning patient preferences), and physician's habit were significant facilitators for physicians working in university hospitals when compared to those working in municipal hospitals.
Conclusion: The facilitators and barriers to implementing SDM in Japan were identified.
Practice Implications: More opportunities for training on SDM are needed to provide knowledge and skills, which will enhance salience and contribute their habitual practice.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
