Department of Clinical Pharmacy andPharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Utrecht University of Applied Sciences, Utrecht, The Netherlands.
Health Expect. 2018 Feb;21(1):64-74. doi: 10.1111/hex.12586. Epub 2017 Jun 21.
Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited.
To explore views of practice staff towards SDM and the DA.
A mixed-methods study within the Dutch PORTDA-diab trial.
Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients.
Interviews were conducted focusing on applicability, usefulness and feasibility of the DA. Interviews were tape-recorded, transcribed verbatim and subjected to content analysis for identifying and classifying views. Patient-reported data about the use of the DA were collected. Associations between specific views and use of the DA were tested using Pearson point-biserial correlation.
The majority of practice staff expressed positive views towards SDM, which was associated with making more use of the DA. Most of the staff expressed that the DA stimulated a two-way conversation. By using the DA, several became aware of their paternalistic approach. Some staff experienced a conflict with the content of the DA, which was associated with making less use of the DA.
The DA was considered useful by practice staff to support SDM. A positive view towards SDM was a facilitator, whereas experiencing a conflict with the content of the DA was a barrier for making use of the DA.
决策辅助工具可用于支持共同决策（SDM）。已经开发了一种针对 2 型糖尿病的以患者为中心的治疗决策辅助工具（DA），但全科医生的使用似乎有限。
探讨实践人员对 SDM 和 DA 的看法。
荷兰 PORTDA-diab 试验中的一项混合方法研究。
包括 17 家实践，其工作人员负责常规糖尿病护理并使用过 DA，以及他们的 209 名患者。
访谈重点关注 DA 的适用性、有用性和可行性。对访谈进行录音、逐字转录，并进行内容分析，以识别和分类观点。收集了患者关于使用 DA 的报告数据。使用 Pearson 点双列相关检验测试特定观点与 DA 使用之间的关联。
大多数实践人员对 SDM 持积极态度，这与更频繁地使用 DA 相关。大多数工作人员表示，DA 激发了双向对话。通过使用 DA，一些人意识到了他们的家长式作风。一些工作人员对 DA 的内容感到冲突，这与较少使用 DA 相关。
实践人员认为 DA 有助于支持 SDM。对 SDM 的积极看法是促进因素，而与 DA 内容发生冲突则是阻碍 DA 使用的因素。
