title: Clinical practice guidelines to improve shared decision-making about assistive device use in home care: a pilot intervention study.
abstract: This study examines whether clinical practice guidelines (CPG) for the introduction of assistive devices (ADs) in home care improve shared decision-making about AD use and modify its social-cognitive correlates. Data were collected in an intervention study with quasi-experimental design. Questionnaires were obtained from 116 home nurses and home care workers and their 140 clients with disabilities. Significant differences between intervention and control group revealed that implementation of CPG improved home nurses' and home care workers' self-reported practice: the number of intervention methods they applied increased, and the methods were applied with increased intensity. Nurses' attitudes towards introducing ADs in a shared decision-making process decreased in both intervention group and control group over time. Clients' reports about caregivers' practice showed a minor concurrence with the reports of the caregivers themselves. The complexity of the CPG and a substantial time investment were reported as the main barriers to involving clients in shared decision-making through the experimental CPG. Nevertheless, CPG hold promise for shared decision-making between formal caregivers and community-dwelling persons with disabilities concerning AD use. The findings suggest that these CPG can structure communication between caregiver and client, and can support caregivers in facilitating clients' self-determination concerning coping with their disabilities.
authors.affiliation: Department of Experimental Clinical and Health Psychology, Ghent, Belgium. marc.roelands@ugent.be
authors.forename: Marc
authors.initials: M
authors.lastname: Roelands
authors.forename: Paulette
authors.initials: P
authors.lastname: Van Oost
authors.forename: Veerle
authors.initials: V
authors.lastname: Stevens
authors.forename: AnneMarie
authors.initials: A
authors.lastname: Depoorter
authors.forename: Ann
authors.initials: A
authors.lastname: Buysse
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001291:Attitude of Health Personnel; D001530:Belgium; D003142:Communication; D003152:Community Health Nursing / Q000458:organization & administration; D003299:Cooperative Behavior; D003659:Decision Making, Organizational; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation; D015577:Geriatric Assessment; D006699:Home Care Services / Q000458:organization & administration*; D018576:Home Health Aides / Q000458:organization & administration / Q000523:psychology*; D006801:Humans; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology*; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D036301:Qualitative Research; D012656:Self-Help Devices / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires