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Medical Students’ Perception Regarding Health Policy Teaching and Their Participation in Health Policy Roles: A Survey at a Public University in Malaysia. Healthcare (Basel) 2022; 10:healthcare10060967. [PMID: 35742019 PMCID: PMC9223141 DOI: 10.3390/healthcare10060967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/14/2022] [Accepted: 05/21/2022] [Indexed: 01/09/2023] Open
Abstract
Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy into the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students’ perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusions: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.
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Sin M, Butt S, Barber SK. Assessing dentist and dental student knowledge of and attitudes towards shared decision-making in the United Kingdom. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:768-777. [PMID: 33386681 DOI: 10.1111/eje.12656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/09/2020] [Accepted: 12/24/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Shared decision-making (SDM) is a partnership between healthcare professionals and patients when choosing care. AIM To measure knowledge of, and attitudes to, SDM amongst undergraduate dental students and dentists in the UK. DESIGN AND SETTING Cross-sectional online questionnaire for 4th and 5th year dental students and dentists in the UK. MATERIALS AND METHODS The questionnaire included attitudinal questions, knowledge of SDM relative to the evidence base and preferred approach to decision-making. The questionnaire identified perceived learning needs and preferred method for SDM teaching for dentists and dental students. Respondents were invited to participate via social media, mailing lists and CPD courses. RESULTS Respondents included 266 undergraduates and 130 dentists. SDM was defined by the people involved, components of the discussion, approach to decision-making and expected outcome. Attitudes to SDM were generally positive although concerns were expressed about patients wanting professionals to make the decision, straying from the professionals' preferred option and compatibility with clinical guidelines. Respondents reported a preference for decision-making to involve patients, but this tended to be an informative rather than deliberative approach. Respondents were least sure of the evidence about the impact of SDM on adherence, choices and health outcomes, and the best approach to risk communication. Respondents from both groups reported an interest in learning more about SDM and its integration into clinical practice. CONCLUSION Knowledge of, and attitude to, SDM in UK dentists and dental undergraduates is generally positive; however, a demand for further SDM training was identified.
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Affiliation(s)
- Melissa Sin
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sara Butt
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Sophy K Barber
- Clinical lecturer and Honorary Consultant Orthodontist, Orthodontics, University of Leeds, Leeds, UK
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Becher S, Holzhüter F, Heres S, Hamann J. Barriers and facilitators of shared decision making in acutely ill inpatients with schizophrenia-Qualitative findings from the intervention group of a randomised-controlled trial. Health Expect 2021; 24:1737-1746. [PMID: 34258833 PMCID: PMC8483208 DOI: 10.1111/hex.13313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/04/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background Shared decision making (SDM) is appreciated as a promising model of communication between clinicians and patients. However, in acute mental health settings, its implementation is still unsatisfactory. Objective The aim of this study is to examine barriers and facilitators of SDM with acutely ill inpatients with schizophrenia. Design A qualitative interview study was performed. Setting and Participants The analysis is based on interviews with participants (patients and staff members) of the intervention group of the randomised‐controlled SDMPLUS trial that demonstrated a significant improvement of SDM measures for patients with schizophrenia on acute psychiatric wards. Main Variables Studied Interviews addressed treatment decisions made during the current inpatient stay. The interviews were analysed using qualitative content analysis. Results A total of 40 interviews were analysed and 131 treatment decisions were identified. According to the interviewees, SDM had taken place in 29% of the decisions, whereas 59% of the decisions were made without SDM. In 16%, a clear judgement could not be made. Barriers and facilitators of SDM were categorised into patient factors, clinician factors, setting factors and others. Clinicians mostly reported patient factors (e.g., symptoms) as barriers towards SDM, which were not mirrored on the patients' side. Facilitators included patient as well as clinician behaviour during consultations. Conclusion Even in the context of a successful SDM intervention, the implementation of SDM for patients in the very acute stages of schizophrenia is often not possible. However, strong facilitators for SDM have also been identified, which should be used for further implementation of SDM. Patient or Public Contribution During the development of the study protocol, meetings with user representatives were held.
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Affiliation(s)
- Stefanie Becher
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Munich, Germany
| | - Fabian Holzhüter
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Munich, Germany
| | | | - Johannes Hamann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Munich, Germany
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Hoffmann T, Gibson E, Barnett C, Maher C. Shared decision making in Australian physiotherapy practice: A survey of knowledge, attitudes, and self-reported use. PLoS One 2021; 16:e0251347. [PMID: 34014934 PMCID: PMC8136718 DOI: 10.1371/journal.pone.0251347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/24/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To assess Australian physiotherapists’ knowledge about, attitudes towards, and self-reported use of shared decision making, as well as perceived barriers to its implementation in practice. Methods Physiotherapists registered for a national Australian physiotherapy conference were invited via email and the conference app to complete a self-administered online questionnaire about shared decision making, including: a) knowledge, b) attitude to and reported approach in practice, c) behaviours used, d) barriers, e) previous training and future training interest. Responses were analysed descriptively and open-ended questions synthesised narratively. Results 372 physiotherapists (71% female, mean age 45 years, mean experience 23 years) completed the survey. Respondents had a good level of knowledge on most questions, with correct responses ranging from 39.5% to 98.5% of participants, and a generally positive attitude towards shared decision making, believing it useful to most practice areas. Sixty percent indicated they make decisions with their patients and there was general agreement between how decisions should be made and how they are actually made. The behaviour with the lowest reported occurrence was explaining the relevant research evidence about the benefits and harms of the options. The main perceived barriers were patient knowledge and confidence, consequent fewer physiotherapy sessions, and time constraints. Most (79%) were keen to learn more about shared decision making. Conclusions Shared decision making is of growing importance to all health professions and rarely studied in physical therapy. This sample of Australian physiotherapists had a generally positive attitude to shared decision making and learning more about it. Opportunities for providing such skills training at the undergraduate level and in continuing professional development should be explored. This training should ensure that the communicating evidence component of shared decision making is addressed as well as debunking myths about perceived barriers to its implementation.
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Affiliation(s)
- Tammy Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
- * E-mail:
| | - Elizabeth Gibson
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Christopher Barnett
- John Hunter Outpatients, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
- Department of Physiotherapy, University of Newcastle, Newcastle, New South Wales, Australia
| | - Christopher Maher
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, Australia
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Moore HL, Farnworth A, Watson R, Giles K, Tomson D, Thomson RG. Inclusion of person-centred care in medical and nursing undergraduate curricula in the UK: Interviews and documentary analysis. PATIENT EDUCATION AND COUNSELING 2021; 104:877-886. [PMID: 33268231 DOI: 10.1016/j.pec.2020.09.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/09/2020] [Accepted: 09/19/2020] [Indexed: 05/25/2023]
Abstract
OBJECTIVE We aimed to understand how person-centred care (PCC) is represented in UK professional standards for undergraduate medical/nursing education and explored how these are reflected in programme provision. METHODS We identified PCC components in medical (GMC) and nursing (NMC) professional standards and university curricula documents provided. We also identified themes from interviews with high-level informants for medical/nursing undergraduate programmes using framework analysis. RESULTS The GMC appears to promote a more paternalistic model of care with discrete PCC components in specific sections and the NMC a more collaborative model with PCC distributed throughout. These differences persisted into education delivery. Medical educators perceived greater barriers to inclusion of PCC than nursing educators; however, both consistently identified cultural and organisational attributes. Clarity was lacking regarding PCC definition, how to teach/assess PCC, and competence expectations. CONCLUSION Development of a PCC skills competence framework would increase consistency and support teaching and assessment in undergraduate curricula. Further research to understand the perspectives of healthcare professionals involved in placements would help inform PCC teaching recommendations. PRACTICE IMPLICATIONS High-level support from senior HEI leaders; multi-disciplinary approaches to curricula development, teaching, and assessment; and greater inclusion of service users would ensure higher quality PCC education for undergraduate students.
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Affiliation(s)
- Heather L Moore
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK.
| | - Allison Farnworth
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rose Watson
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Karen Giles
- Faculty of Health Sciences & Wellbeing, University of Sunderland, Sunderland, UK
| | - David Tomson
- Collingwood Surgery, Collingwood Health Group, North Shields, UK
| | - Richard G Thomson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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van der Kraaij GE, Vermeulen FM, Smeets PMG, Smets EMA, Spuls PI. The current extent of and need for shared decision making in atopic dermatitis and psoriasis in the Netherlands: an online survey study amongst patients and physicians. J Eur Acad Dermatol Venereol 2020; 34:2574-2583. [PMID: 32163645 PMCID: PMC7818257 DOI: 10.1111/jdv.16340] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/14/2020] [Indexed: 12/02/2022]
Abstract
Background In shared decision making (SDM), patients and physicians work together to choose the best treatment option for an individual patient. Atopic dermatitis (AD) and psoriasis are particularly suitable for SDM, considering that the best treatment option depends on a patient’s preferences and values (preference‐sensitive decisions). Currently, it is unknown to what extent SDM is applied in treatment decisions for these diseases in the Netherlands. Objectives Primary, to assess the current extent of SDM in AD and psoriasis in the Netherlands amongst patients and dermatologists. Secondary, to assess the degree to which patients and physicians endorse SDM, to explore which characteristics are related to their preference to be involved in SDM and to identify which barriers and facilitators for SDM they perceive. Methods Two similar online surveys, one for patients with AD or psoriasis and one for (resident) dermatologists, were carried out. The surveys comprised validated questionnaires (shared decision making questionnaire (SDM‐Q; range 0–100), Control Preference Scale) and study‐specific statements mainly regarding barriers and facilitators for SDM. Results The responses of 219 patients and 147 physicians were analysed. Dermatologists experienced significantly more SDM than patients (SDM‐Q 82 vs 55; P < 0.01). Most patients and dermatologists prefer to share treatment decisions. Mainly facilitators for SDM were perceived, including the positive perception of patients and dermatologists regarding SDM. The perceived barriers included lack of continuity of care by the same physician and lack of time. Conclusion Despite the dermatologists’ optimistic perspective, patients experience a limited extent of SDM and physicians should be aware of this gap. Improvement of SDM in AD and psoriasis is needed. The positive attitude of patients and dermatologists towards the process and outcome of SDM is important facilitators, while barriers were mainly perceived on an organizational level.
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Affiliation(s)
- G E van der Kraaij
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F M Vermeulen
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P M G Smeets
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - E M A Smets
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P I Spuls
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Barber SK, Ryan F, Cunningham SJ. Knowledge of, and attitudes to, shared decision-making in orthodontics in the UK. J Orthod 2020; 47:294-302. [PMID: 32693666 DOI: 10.1177/1465312520941526] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To establish UK orthodontic treatment providers' knowledge of, and attitudes to, shared decision-making (SDM). SDM involves patients as equal partners in decisions about treatment. DESIGN Cross-sectional survey. SETTING Online survey across the UK. POPULATION Dentists and orthodontists providing orthodontic treatment in the UK. METHODS Potential participants were contacted through the British Orthodontic Society mailing lists. An online survey was developed to examine knowledge of, and attitudes to, SDM using a combination of evidence-based statements and free text boxes. Questions regarding previous training in SDM and preferences for further training were also included. RESULTS The survey was completed by 210 respondents, yielding an approximate response rate of 15%. Respondents were mainly consultants (34%) and specialist orthodontists (42%). SDM was well described in terms of the people involved in this process, how it is approached, the components and topics of discussion, and the overall purpose of SDM. Generally, there was consistency in attitudinal responses, with the largest variance in responses to questions about the professional-patient partnership, the interface between SDM and clinical guidelines, and accepting a decision that is discordant with the professional's opinion. Fifty-one respondents reported having some previous teaching/training in SDM, with the majority (87%) indicating that they would like more training. CONCLUSION Clinicians providing orthodontic treatment in the UK have a good understanding of the meaning of shared decision-making. Concerns raised about using SDM and knowledge gaps suggest there is value in providing SDM training for the orthodontic team and that orthodontic providers would welcome it.
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Affiliation(s)
- Sophy K Barber
- Orthodontic Department, School of Dentistry, University of Leeds, Leeds, UK
| | - Fiona Ryan
- Eastman Dental Hospital, UCLH Foundation Trust, London, UK
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Yen RW, Barr PJ, Cochran N, Aarts JW, Légaré F, Reed M, O'Malley AJ, Scalia P, Painchaud Guérard G, Backer G, Reilly C, Elwyn G, Durand MA. Medical Students' Knowledge and Attitudes Toward Shared Decision Making: Results From a Multinational, Cross-Sectional Survey. MDM Policy Pract 2019; 4:2381468319885871. [PMID: 31742232 PMCID: PMC6843737 DOI: 10.1177/2381468319885871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 08/19/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction. We aimed to conduct a multinational cross-sectional online survey of medical students' attitudes toward, knowledge of, and experience with shared decision making (SDM). Methods. We conducted the survey from September 2016 until May 2017 using the following: 1) a convenience sample of students from four medical schools each in Canada, the United States, and the Netherlands (n = 12), and 2) all medical schools in the United Kingdom through the British Medical School Council (n = 32). We also distributed the survey through social media. Results. A total of 765 students read the information sheet and 619 completed the survey. Average age was 24, 69% were female. Mean SDM knowledge score was 83.6% (range = 18.8% to 100%; 95% confidence interval [CI] = 82.8% to 84.5%). US students had the highest knowledge scores (86.2%, 95% CI = 84.8% to 87.6%). The mean risk communication score was 57.4% (range = 0% to 100%; 95% CI = 57.4% to 60.1%). Knowledge did not vary with age, race, gender, school, or school year. Attitudes were positive, except 46% believed SDM could only be done with higher educated patients, and 80.9% disagreed that physician payment should be linked to SDM performance (increased with years in training, P < 0.05). Attitudes did not vary due to any tested variable. Students indicated they were more likely than experienced clinicians to practice SDM (72.1% v. 48.8%). A total of 74.7% reported prior SDM training and 82.8% were interested in learning more about SDM. Discussion. SDM knowledge is high among medical students in all four countries. Risk communication is less well understood. Attitudes indicate that further research is needed to understand how medical schools deliver and integrate SDM training into existing curricula.
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Affiliation(s)
- Renata W Yen
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Paul J Barr
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Nan Cochran
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Johanna W Aarts
- Department of Obstetrics & Gynecology, Radboudumc University Medical Center, Nijmegen, The Netherlands
| | - France Légaré
- Université Laval, Department of Family Medicine, Quebec City, Quebec, Canada
| | - Malcolm Reed
- Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, UK
| | - A James O'Malley
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Peter Scalia
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Geneviève Painchaud Guérard
- CHU de Quebec Research Center Université Laval, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada
| | - Grant Backer
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Clifford Reilly
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Marie-Anne Durand
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire
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Rabathaly PA, Chattu VK. Sexual healthcare knowledge, attitudes, and practices among primary care physicians in Trinidad and Tobago. J Family Med Prim Care 2019; 8:614-620. [PMID: 30984683 PMCID: PMC6436309 DOI: 10.4103/jfmpc.jfmpc_322_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Our understanding of healthcare professionals' competence level in both their sexual history taking practices and their attitudes in addressing sexual health concerns of patients in middle and old age is lacking. This research aimed to assess primary care physicians' (PCPs) knowledge, attitudes, and sexual healthcare practices toward patients who are ≥45 years in Trinidad and Tobago. MATERIALS AND METHODS A self-reported survey instrument assessing clinical sexual health knowledge, attitudes, and practices was administered nationwide to all registered PCPs (n = 155) in the public healthcare service. Descriptive and inferential statistical analyses were conducted using STATA. RESULTS PCPs, who were foreign medical graduates, middle-aged, male, and worked in urban centers, had improved odds of discussing sexual health with middle-aged and older patients. PCPs with any training in sexual health communication or sexual history taking were three times more likely to initiate a sexual health discussion or take a sexual history. Over 90% of physicians reported taking a sexual history only if the discussion was patient initiated and over 50% of PCPs indicated they will not ask these older patients about their sexual orientation, sexual partners, sexual abuse, or violence. CONCLUSIONS Even though PCPs reported having a positive willing attitude toward offering sexual health care to these patients, they had a low level of knowledge of sexual function in later life and inconsistent sexual history taking practices. There is a great need for training physicians' on sexual health communication and history taking and on sexual function in older adults.
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Affiliation(s)
- Patrice A. Rabathaly
- Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Vijay Kumar Chattu
- Public Health and Primary Care Unit, Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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Forcino RC, Yen RW, Aboumrad M, Barr PJ, Schubbe D, Elwyn G, Durand MA. US-based cross-sectional survey of clinicians' knowledge and attitudes about shared decision-making across healthcare professions and specialties. BMJ Open 2018; 8:e022730. [PMID: 30341128 PMCID: PMC6196864 DOI: 10.1136/bmjopen-2018-022730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE In this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties. SETTING We administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017. PARTICIPANTS 272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US. RESULTS We found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making. CONCLUSIONS Recent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.
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Affiliation(s)
- Rachel C Forcino
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
| | - Renata West Yen
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
| | - Maya Aboumrad
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
- White River Junction VA Medical Center, White River Junction, Vermont, USA
| | - Paul J Barr
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
| | - Danielle Schubbe
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
| | - Marie-Anne Durand
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA
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