Prediction of health professionals' intention to screen for decisional conflict in clinical practice.
OBJECTIVE
To identify the determinants of the intention of physicians to screen for decisional conflict in clinical practice.


BACKGROUND
Screening for decisional conflict is one of the key competencies when educating health professionals about shared decision making. Theory-based knowledge about variables predicting their intention to screen for decisional conflict in clinical practice would help design effective implementation interventions in this area.


METHODS
Data of two cross-sectional surveys embedded within a large implementation study of the Ottawa Decision Support Framework (ODSF) in primary care.


METHODS
In total, 122 health professionals from five family practice teaching units.


METHODS
Intention to screen for decisional conflict in clinical practice was defined as the intention to use the clinical version of the Decisional Conflict Scale (DCS) with patients at the end of the clinical encounter. It was assessed at the entry and the exit from this study. Both intentions were entered as a dependent variable in multivariate analyses.


RESULTS
At entry, the intention was influenced by: attitude (P < 0.001), subjective norm (P < 0.001), perceived behavioural control (P < 0.001) and clinical site (P < 0.05). On exit, it was influenced by: subjective norm (P < 0.001), perceived behavioural control (P < 0.001), clinical site (P < 0.05), international Continuing Medical Education (CME) (P < 0.05), other diplomas (P < 0.05) and intervention (P < 0.05). In post hoc analyses, there was a statistically significant difference between entry and exit in the impact of the level of exposure to the multifaceted implementation intervention on the intention (P = 0.003).


CONCLUSIONS
Variables predicting the intention of health professionals to screen for decisional conflict in clinical practice using the DCS change over time suggesting that effective implementation interventions in this area will need to be modified longitudinally.
Légaré
France
F
Department of Family Medicine, Université Laval, Québec, QC, Canada. france.legare@mfa.ulaval.ca
Graham
Ian D
ID
O'Connor
Annette C
AC
Aubin
Michèle
M
Baillargeon
Lucie
L
Leduc
Yvan
Y
Maziade
Jean
J
D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D011795:Surveys and Questionnaires