Experiences of the use of the iPad app ADOC for collaborative goal setting in interprofessional rehabilitation: a qualitative descriptive study (Preprint)

2021 ◽  
Author(s):  
Carla Strubbia ◽  
William M.M. Levack ◽  
Rebecca Grainger ◽  
Kayoko Takahashi ◽  
Kounosuke Tomori
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Shared Decision Making ◽  
Goal Setting ◽  
Health Professionals ◽  
Occupational Choice ◽  
Shared Decision ◽  
Allied Health Professionals ◽  
Language Version ◽  
Ipad App

BACKGROUND Goal setting is a key part of the rehabilitation process. The use of technology and electronic tools such as smartphone applications (apps) and websites has been suggested as a way of improving the engagement of users in meaningful goal-setting and facilitating shared decision-making between patients and health professionals. OBJECTIVE To describe experiences of health professionals and patients in the use of the English language version of the iPad app Aid for Decision-making in Occupational Choice (ADOC) to facilitate collaborative goal setting in rehabilitation. METHODS We recruited participants from three acute and post-acute care rehabilitation wards in both public and private organizations in New Zealand. Participants were registered allied health professionals including physiotherapists, occupational therapists, and speech-language therapists, who engage in goal setting as part of their normal work, and their adult patients. We collected data via semi-structured interviews to gather information about the experiences of the participants in the use of ADOC for goal setting. Data were analyzed with thematic analysis. RESULTS Eight health professionals and eight patients participated in the study. Six main themes emerged from the data: a) Changing patients’ perspective on what is possible; b) Changing health professionals’ perspective on what is important; c) Facilitating shared decision-making; d) Lack of guides for users; e) Logistic and organizational barriers; and f) App related and technical issues. CONCLUSIONS Health professionals and patients found ADOC to be a valuable tool when setting shared rehabilitation goals. The use of ADOC promoted a patient-centered approach that empowered patients to engage in collaborative goal setting. The technological limitations of the app that negatively impacted experiences can be addressed in the future implementation of ADOC in rehabilitation settings. CLINICALTRIAL The trial was retrospectively registered and allocated to the Australian New Zealand Clinal Trial Registry (ACTRN) number ACTRN12620001328965.

scholarly journals Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 2128
Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Shared Decision ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Societies ◽  
New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

Patient-important Outcomes to Inform Shared Decision Making and Goal Setting for Diabetes Treatment

2021 ◽  
Author(s):  
Kristin L. Rising ◽  
Alexzandra T. Gentsch ◽  
Geoffrey Mills ◽  
Marianna LaNoue ◽  
Amanda M.B. Doty ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Goal Setting ◽  
Shared Decision ◽  
Diabetes Treatment

scholarly journals Perioperative shared decision-making in the Bay of Plenty, New Zealand: Audit results from a complex decision pathway quality improvement initiative using a structured communication tool

2020 ◽  
Vol 48 (6) ◽  
pp. 473-476
Author(s):  
Heidi C Omundsen ◽  
Renee L Franklin ◽  
Vicki L Higson ◽  
Mark S Omundsen ◽  
Jeremy I Rossaak
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Shared Decision Making ◽  
Elective Surgery ◽  
Quality Improvement Initiative ◽  
Health Board ◽  
Shared Decision ◽  
Communication Tool ◽  
Complex Decision ◽  
Structured Communication

Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk–benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperative medicine service. We describe the setup of a complex decision pathway within our district health board and report on the audit data from our first 49 patients. The complex decision pathway encourages surgeons to identify high-risk patients who will benefit from shared decision-making, manages input from multiple specialists as needed with excellent communication between those specialists, and provides a patient-centred approach to decision-making using a structured communication tool.

scholarly journals Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Espen W. Haugom ◽  
Bjørn Stensrud ◽  
Gro Beston ◽  
Torleif Ruud ◽  
Anne S. Landheim
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychotic Disorders ◽  
Successful Implementation ◽  
Practical Training ◽  
Shared Decision ◽  
Antipsychotic Medications

Abstract Background Shared decision-making (SDM) is a process whereby clinicians and patients work together to select treatments based on both the patient’s preferences and clinical evidence. Although patients with psychotic disorders want to participate more in decisions regarding their care, they have limited opportunities to do so because of various barriers. Knowing about health professionals’ experiences with SDM is important toward achieving successful implementation. The study aim was to describe and explore health professionals’ SDM experiences with patients with psychotic disorders. Methods Three focus group interviews were conducted, with a total of 18 health professionals who work at one of three Norwegian community mental health centres where patients with psychotic disorders are treated. We applied a descriptive and exploratory approach using qualitative content analysis. Results Health professionals primarily understand the SDM concept to mean giving patients information and presenting them with a choice between different antipsychotic medications. Among the barriers to SDM, they emphasized that patients with psychosis have a limited understanding of their health situation and that time is needed to build trust and alliances. Health professionals mainly understand patients with psychotic disorders as a group with limited abilities to make their own decisions. They also described the concept of SDM with little consideration of presenting different treatment options. Psychological or social interventions were often presented as complementary to antipsychotic medications, rather than as an alternative to them. Conclusion Health professionals’ understanding of SDM is inconsistent with the definition commonly used in the literature. They consider patients with psychotic disorders to have limited abilities to participate in decisions regarding their own treatment. These findings suggest that health professionals need more theoretical and practical training in SDM.

scholarly journals Chinese international students travelling with friends: Group decision-making and disagreement prevention

2021 ◽  
Author(s):  
◽  
Hanru Zhu
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
International Students ◽  
Shared Decision Making ◽  
Group Decision Making ◽  
Group Decision ◽  
Chinese International Students ◽  
Decision Making Process ◽  
Shared Decision ◽  
Decision Making Model

<p>This thesis investigates the group decision-making process of Chinese international students travelling with friends in New Zealand. Focusing on groups of friends, a neglected decision-making unit, it explores models of group decision-making and disagreement prevention and resolution strategies of Chinese international students making travel-related decisions. Qualitative research method governed by the interpretive paradigm was adopted. Sixteen Chinese international students from Victoria University of Wellington were interviewed. They were from eleven travel groups and had experience of independent leisure travel in non-family groups in New Zealand. Given that Chinese independent visitor market to New Zealand keeps growing, and Chinese international students have been referred as “China's first wave of independent travellers” (King & Gardiner, 2015), this study adds knowledge to the understanding of the travel behaviours and decision-making process of this market travelling in New Zealand.  Tourism attractions were the most discussed travel-related decision during the group decision-making process, followed by decisions on travel activities, food and restaurants, accommodation and transportation. Three group decision-making models were identified: leadership, division of work, and shared decision-making. Leadership includes three roles of leaders, namely the travel initiator who has the initial idea for the trip and who gets potential members together, the main plan-provider who is responsible for collecting travel information and travel tips to make the whole travel plan and arrange travel schedules, and the main decision-maker who makes the final decision in the travel group. The former two roles are with less dominance, while the latter is with higher dominance in the decision-making process. The division of work model refers to dividing the tasks (e.g. organising accommodation or transport) within the travel group and includes two roles: the plan-provider who is responsible for making the plan for the allocated task, and the decision-maker who made the decision on the allocated task. In the shared decision-making model, the group members make the travel-related decisions collectively by discussion and voting.  Most travel groups were found to use multiple group decision-making models conjointly, with a few groups only using the shared decision-making model. Overall, the most used models were shared decision-making and leadership. Most travel group who adopted the leadership model tended to then use either shared decision-making model or the division of work model depending on the level of dominance of group leader.  Most interviewees indicated that there was lack of disagreement during the group decision-making process. Thus the research focus has shifted from the disagreement resolution to the disagreement prevention. Five disagreement prevention strategies and one influencing factor were identified: travelling with like-minded people, adequate preparation, empathy and mutual understanding, tolerance, compensation and external factors. If disagreements occurred, one or more of tight strategies were adopted by the interviewees to resolve them, namely making concessions, discussing and voting, looking for alternatives, persuasion, toleration, splitting up, accommodating and delaying. Implications and recommendation for industries and future studies are discussed.</p>

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