[Patient involvement: the physician's view--a qualitative survey].
OBJECTIVE
Patient involvement (PI) and shared decision making (SDM) have increasingly come into the focus of (inter-)national research. SDM, however, is not a standard component of standard care so far. Therefore it is of importance to take into consideration all parties concerned. This article points out the barriers physicians see; one group has not been interrogated on this topic often.


METHODS
25 physicians at a clinical centre were interviewed about decision-making processes within their environment, their concerns as well as their ideas towards PI. The consultations were realized with the help of a guideline-oriented questionnaire. The outcome was then interpreted by means of the thematic content analysis.


RESULTS
A system of categories was constructed containing 28 categories on the micro-, meso-, and macro-level. From a physician's perspective, changes are necessary on all levels to achieve patient involvement and SDM. Essential points of approach for this are: sufficient time and personnel, sufficient communicative abilities in physicians, and a solid physician-patient relationship as well as changes in healthcare politics.


CONCLUSIONS
To consistently improve patient involvement and SDM, physicians' concerns must be taken seriously. Here SDM can only be properly applied by taking into account the meso- and macro-level. Furthermore, it would be helpful to clear up the conceptually vague aspects of SDM, which would also help to communicate the concept more clearly.
Rockenbauch
Katrin
K
Selbständige Abteilung für Medizinische Psychologie und Medizinische Soziologie Universität Leipzig.
Geister
Christina
C
Appel
Claudia
C
D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D005858:Germany; D006291:Health Policy; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010353:Patient Education as Topic; D010358:Patient Participation; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D036301:Qualitative Research; D011795:Surveys and Questionnaires