Healthcare professionals' views on factors influencing shared decision‐making in primary health care centres in Saudi Arabia: A qualitative study

Author(s):  
Nouf Alsulamy ◽  
Andrew Lee ◽  
Praveen Thokala
Medicine ◽  
2020 ◽  
Vol 99 (32) ◽  
pp. e21389
Author(s):  
Valle Coronado-Vázquez ◽  
Carlota Canet-Fajas ◽  
Maria Teresa Delgado-Marroquín ◽  
Rosa Magallón-Botaya ◽  
Macarena Romero-Martín ◽  
...  

2015 ◽  
Vol 5 (2) ◽  
pp. 53-59
Author(s):  
Ted Epperly ◽  
Richard Roberts ◽  
Salman Rawaf ◽  
Chris Van Weel ◽  
Robert Phillips ◽  
...  

 Background: Person-centered primary health care provides first contact care that is comprehensive, continuous, accessible, compassionate, caring, team-based, and above all else person-centered. Primary care by its very nature is integrative in design and process. It connects and coordinates care for the person and uses shared decision making to help value and respect the person’s choices as they navigate through a complex and fragmented health care system.  Objectives: To demonstrate the effectiveness of primary care in achieving the triple aim of better health, better health care, and lower cost. Methods: Critical literature review and evidence based analysis of person-centered primary health care across the world.  Results: Primary care is a systems integrator and improves both the quality of care and the lowering of cost to both people and populations. It has been found that the better a country’s primary care system is, the country will have better overall health care outcomes and lower per capita health care expenditures. Evidence also demonstrates that person-centeredness contributes to higher quality care and better health outcomes. Comprehensiveness of care leads to better health outcomes, lower all-cause mortality, better access to care, less re-hospitalization, fewer consultations with specialists, less use of emergency services, and better detection of adverse effects of medical interventions. The use of the relationship of trust established through primary care health professionals in shared decision making is an effective and efficient means to promote behavior change that results in the triple aim of better health, improved healthcare, and lower costs.  Conclusions: All nations must build a robust and vibrant person-centered primary health care system based on the principles of continuity, comprehensiveness, and person-centeredness. This is important now more than ever to prioritize and rebalance health care systems to address the health care needs of the people that are served. 


BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e053937
Author(s):  
Jane Noyes ◽  
Gareth Roberts ◽  
Gail Williams ◽  
James Chess ◽  
Leah Mc Laughlin

ObjectivesTo explore how people with chronic kidney disease who are pre-dialysis, family members and healthcare professionals together navigate common shared decision-making processes and to assess how this impacts future treatment choice.DesignCoproductive qualitative study, underpinned by the Making Good Decisions in Collaboration shared decision-model. Semistructured interviews with a purposive sample from February 2019 - January 2020. Interview data were analysed using framework analysis. Coproduction of logic models/roadmaps and recommendations.SettingFive Welsh kidney services.Participants95 participants (37 patients, 19 family members and 39 professionals); 44 people supported coproduction (18 patients, 8 family members and 18 professionals).FindingsShared decision-making was too generic and clinically focused and had little impact on people getting onto home dialysis. Preferences of where, when and how to implement shared decision-making varied widely. Apathy experienced by patients, caused by lack of symptoms, denial, social circumstances and health systems issues made future treatment discussions difficult. Families had unmet and unrecognised needs, which significantly influenced patient decisions. Protocols containing treatment hierarchies and standards were understood by professionals but not translated for patients and families. Variation in dialysis treatment was discussed to match individual lifestyles. Patients and professionals were, however, defaulting to the perceived simplest option. It was easy for patients to opt for hospital-based treatments by listing important but easily modifiable factors.ConclusionsShared decision-making processes need to be individually tailored with more attention on patients who could choose a home therapy but select a different option. There are critical points in the decision-making process where changes could benefit patients. Patients need to be better educated and their preconceived ideas and misconceptions gently challenged. Healthcare professionals need to update their knowledge in order to provide the best advice and guidance. There needs to be more awareness of the costs and benefits of the various treatment options when making decisions.


2015 ◽  
Vol 19 (2) ◽  
pp. 448-458 ◽  
Author(s):  
Simone Farrelly ◽  
Helen Lester ◽  
Diana Rose ◽  
Max Birchwood ◽  
Max Marshall ◽  
...  

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