title: Exploring dietitians' salient beliefs about shared decision-making behaviors.
abstract: BACKGROUND
  Shared decision making (SDM), a process by which health professionals and patients go through the decision-making process together to agree on treatment, is a promising strategy for promoting diet-related decisions that are informed and value based and to which patients adhere well. The objective of the present study was to identify dietitians' salient beliefs regarding their exercise of two behaviors during the clinical encounter, both of which have been deemed essential for SDM to take place: (1) presenting patients with all dietary treatment options for a given health condition and (2) helping patients clarify their values and preferences regarding the options.
  
  
  METHODS
  Twenty-one dietitians were allocated to four focus groups. Facilitators conducted the focus groups using a semistructured interview guide based on the Theory of Planned Behavior. Discussions were audiotaped, transcribed verbatim, coded, and analyzed with NVivo8 (QSR International, Cambridge, MA) software.
  
  
  RESULTS
  Most participants stated that better patient adherence to treatment was an advantage of adopting the two SDM behaviors. Dietitians identified patients, physicians, and the multidisciplinary team as normative referents who would approve or disapprove of their adoption of the SDM behaviors. The most often reported barriers and facilitators for the behaviors concerned patients' characteristics, patients' clinical situation, and time.
  
  
  CONCLUSIONS
  The implementation of SDM in nutrition clinical practice can be guided by addressing dietitians' salient beliefs. Identifying these beliefs also provides the theoretical framework needed for developing a quantitative survey questionnaire to further study the determinants of dietitians' adoption of SDM behaviors.
authors.affiliation: CHUQ Research Center, Centre Hospitalier Universitaire de Québec-Hôpital St-François-d'Assise, Québec, QC, Canada. sophie.desroches@fsaa.ulaval.ca
authors.forename: Sophie
authors.initials: S
authors.lastname: Desroches
authors.forename: Annie
authors.initials: A
authors.lastname: Lapointe
authors.forename: Sarah-Maude
authors.initials: SM
authors.lastname: Deschênes
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D000328:Adult; D003657:Decision Making; D004046:Dietetics; D055317:Evidence-Based Practice; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008962:Models, Theoretical; D010349:Patient Compliance; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013637:Tape Recording