Department of Family Medicine, McGill University, Montréal, Canada; Mila-Quebec AI Institute, Montreal, Canada.
Department of Family Medicine, McGill University, Montréal, Canada; Lady Davis Institute for Medical Research, Montreal, Canada.
Patient Educ Couns. 2024 Nov;128:108373. doi: 10.1016/j.pec.2024.108373. Epub 2024 Jul 14.
To 1) examine the willingness of residents to undertake shared decision-making and 2) explore whether the willingness to engage in shared decision-making is influenced by the perceived stakes of a clinical situation.
Sequential mixed methods design. Phase One: Family Medicine residents completed IncorpoRATE, a seven-item measure of clinician willingness to engage in shared decision making. Mean IncorpoRATE scores were calculated. Phase Two: We interviewed residents from phase one to explore their perceptions of high versus low stakes situations. Transcripts were analyzed using qualitative content analysis.
IncorpoRATE scores indicated a greater willingness to engage in shared decision-making when the stakes of the decision were perceived as low (7.59 [2.0]) compared to high (4.38 [2.5]). Interviews revealed that residents held variable views of the stakes of similar clinical decisions.
Residents are more willing to engage in shared decision-making when the stakes of the situation are perceived to be low. However, the interpretation of the stakes of clinical situations varies.
Further research is needed to explore how shared decision making is understood by residents in Family Medicine and when they view the process of shared decision-making to be most appropriate.
1）考察住院医师是否愿意参与共同决策，2）探讨对临床情况的重视程度是否会影响参与共同决策的意愿。
顺序混合方法设计。第一阶段：家庭医学住院医师完成了 IncorpoRATE，这是一项衡量临床医生参与共同决策意愿的七项措施。计算了 IncorpoRATE 的平均得分。第二阶段：我们对第一阶段的住院医师进行了访谈，以探讨他们对高风险和低风险情况的看法。使用定性内容分析对转录本进行了分析。
当决策的利害关系被认为较低（7.59 [2.0]）时，IncorpoRATE 评分表明更愿意参与共同决策，而当利害关系被认为较高（4.38 [2.5]）时则不然。访谈显示，住院医师对类似临床决策的利害关系持有不同的看法。
当情况的利害关系被认为较低时，住院医师更愿意参与共同决策。然而，对临床情况利害关系的解释因人而异。
需要进一步研究如何让家庭医学的住院医师理解共同决策，以及他们认为何时最适合共同决策过程。
