Amsterdam University Medical Center, University of Amsterdam, Department of Obstetrics and Gynaecology, the Netherlands.
The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.
Patient Educ Couns. 2022 Aug;105(8):2785-2792. doi: 10.1016/j.pec.2022.04.002. Epub 2022 Apr 19.
The implementation of shared decision-making and patient decision aids (PDAs) is impeded by clinicians' attitudes.
To develop a measure of clinician attitude towards PDAs.
To develop the ADOPT measure, we used four stages, culminating in measure responses by medically qualified clinicians, 25 from each of the following specialties: emergency medicine, family medicine, oncology, obstetrics and gynaecology, orthopaedics, and psychiatry. To assess validity, we also posed three questions to assess the participants' attitudinal and behavioural endorsement of PDAs. Allocating a point per adjective, we calculated the sum as well as positive and negative scores. We used univariate logistic regression to determine associations between the scores and attitudinal or behavioural endorsements.
152 clinicians completed the measure. 'Time-saving' (39%) and 'easy' (34%) were the most frequently selected adjectives. 'Time-consuming' and 'unfamiliar' were the most frequently selected negative adjectives (both 19%). The sum scores were significantly associated with behavioural endorsement of PDAs.
Clinicians were able to respond to adjective-selection methods and the ADOPT measure could help assess clinician attitudes to PDAs. Validation will require further research.
The ADOPT measure could help identify the extent and source of attitudinal resistance.
共享决策和患者决策辅助工具（PDAs）的实施受到临床医生态度的阻碍。
开发一种衡量临床医生对 PDAs 态度的工具。
为了开发 ADOPT 工具，我们使用了四个阶段，最终由以下每个专业的医学合格临床医生回答：急诊医学、家庭医学、肿瘤学、妇产科、骨科和精神病学，各 25 名。为了评估有效性，我们还提出了三个问题来评估参与者对 PDAs 的态度和行为认可。我们为每个形容词分配一个点，计算总和以及正负分数。我们使用单变量逻辑回归来确定分数与态度或行为认可之间的关联。
152 名临床医生完成了该测量。“节省时间”（39%）和“简单”（34%）是最常被选择的形容词。“耗时”和“不熟悉”是最常被选择的负面形容词（均为 19%）。总分与 PDAs 的行为认可显著相关。
临床医生能够对形容词选择方法做出反应，ADOPT 工具可以帮助评估临床医生对 PDAs 的态度。验证还需要进一步的研究。
ADOPT 工具可以帮助确定态度抵制的程度和来源。
