title: Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: a mixed methods study.
abstract: In an interprofessional approach to shared decision-making (IP-SDM), an interprofessional team collaborates in identifying best options and helps patients determine their preferences, enabling them to take more control over the treatment plan. However, little is known about fostering IP-SDM in Canada's healthcare system. Therefore, we sought to evaluate health professionals' intentions to engage in IP-SDM in home care and explore the factors associated with this intention. A total of 272 eligible home care providers completed a questionnaire based on the theory of planned behavior. Eight managers and one healthcare team caring for the frail elderly were interviewed about possible barriers and facilitators. Analysis involved descriptive statistics and multivariate analysis of quantitative data and content analysis of qualitative data. On a scale of - 3 (strongly disagree) to +3 (strongly agree), the mean intention to engage in IP-SDM was positive (1.42 ± 1.39). The intention was influenced by the following theory-based determinants (R(2) = 57%; p ≤ 0.002), i.e. cognitive attitude (p < 0.001) subjective norm (p < 0.0001) and perceived behavioral control (p < 0.0001), with variations depending on the type of provider. Barriers included lack of time, poor team cohesion and high staff turnover. Facilitators included team cohesion and shared tools. Future programs implementing IP-SDM could address these barriers and facilitators.
authors: Family Medicine and Emergency Medicine, Université Laval, Quebec City, Quebec, Canada. france.legare@mfa.ulaval.ca
authors: France
authors: F
authors: Légaré
authors: Dawn
authors: D
authors: Stacey
authors: Nathalie
authors: N
authors: Brière
authors: Kimberley
authors: K
authors: Fraser
authors: Sophie
authors: S
authors: Desroches
authors: Serge
authors: S
authors: Dumont
authors: Anne
authors: A
authors: Sales
authors: Carole
authors: C
authors: Puma
authors: Denise
authors: D
authors: Aubé
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D003657:Decision Making; D005260:Female; D006282:Health Personnel / Q000458:organization & administration / Q000523:psychology*; D006302:Health Services Research; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D033182:Intention; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D010358:Patient Participation
references: BMC Health Serv Res. 2011 Jan 31;11:23
references: 21281487
references: J Eval Clin Pract. 2011 Aug;17(4):554-64
references: 20695950
references: Fam Med. 2009 Feb;41(2):126-33
references: 19184691
references: Patient Educ Couns. 2010 Aug;80(2):164-72
references: 19945813
references: Cochrane Database Syst Rev. 2011 Oct 05;(10):CD001431
references: 21975733
references: Implement Sci. 2008 Jul 16;3:36
references: 18631386
references: Patient Educ Couns. 2008 Dec;73(3):526-35
references: 18752915
references: Acad Med. 2011 Aug;86(8):1010-8
references: 21694569
references: Med Educ Online. 2011 Apr 08;16:
references: 21519399
references: Health Expect. 2011 Mar;14 Suppl 1:96-110
references: 20629764
references: J Interprof Care. 2005 May;19 Suppl 1:21-38
references: 16096143
references: J Contin Educ Health Prof. 2012 Spring;32(2):98-107
references: 22733637
references: J Interprof Care. 2011 Jan;25(1):18-25
references: 20795835
references: J Interprof Care. 2011 Mar;25(2):124-30
references: 21182442
references: J Gen Intern Med. 2005 Jun;20(6):531-5
references: 15987329
references: Cochrane Database Syst Rev. 2008 Jan 23;(1):CD002213
references: 18254002
references: J Cancer Educ. 2012 Jun;27(3):456-62
references: 22539055
references: J Interprof Care. 2011 Nov;25(6):399-400
references: 21732722
references: Worldviews Evid Based Nurs. 2008;5(1):25-35
references: 18266768