TY - JOUR
T1 - An observational study on the process of collaborative deliberation in arranging long-term care
T2 - The perception of clients and professionals
AU - van Leersum, Catharina M.
AU - van Steenkiste, Ben
AU - Wolf, Judith R.L.M.
AU - van der Weijden, Trudy
AU - Moser, Albine
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the ZonMw (grant number 516012507), the Netherlands Organizations for Health Research and Development, The Hague, the Netherlands (project number: 516012507). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing and publishing the report.
Publisher Copyright:
© The Author(s) 2021.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Background: Clients are invited to play a role in decisions about their care. Collaborative deliberation comprises constructive engagement, recognition of alternative actions, comparative learning, construction and elicitation of preferences and preference integration. Collaborative deliberation between clients and professionals is a process that requires an interest in each other, sharing of views on alternatives and preferences and integrating into decisions. The aim is to gain insight into collaborative deliberation in consultations and the clients’ perception of arranging long-term care. Design: A descriptive qualitative study to explore collaborative deliberation in consultations between clients and professionals. Six organisations providing long-term care were included. Data collection of nine clients involved observations of consultation with field notes and audio-records, interviews with clients and professionals shortly and 3–6 months after the consultation and questionnaires to collect background information. The data were analysed by deductive content analysis. Findings: Constructive engagement was visible in all consultations. Clients and professionals showed respect, empathy and curiosity towards each other. In most consultations, two or more alternative actions are recognised and discussed. Comparative learning appears to be two sided, the client and the professional learn from each other's knowledge and experiences. Construction and elicitation of preference, and preference integration, seems to be present, but difficult to recognise in all consultations. Discussion/conclusion: Although all propositions could be identified, there seems room for improvement in preference elicitation and integration of these preferences in the discussions on courses of action. Assistance seems needed with preference elicitation, both for the clients and for the professional.
AB - Background: Clients are invited to play a role in decisions about their care. Collaborative deliberation comprises constructive engagement, recognition of alternative actions, comparative learning, construction and elicitation of preferences and preference integration. Collaborative deliberation between clients and professionals is a process that requires an interest in each other, sharing of views on alternatives and preferences and integrating into decisions. The aim is to gain insight into collaborative deliberation in consultations and the clients’ perception of arranging long-term care. Design: A descriptive qualitative study to explore collaborative deliberation in consultations between clients and professionals. Six organisations providing long-term care were included. Data collection of nine clients involved observations of consultation with field notes and audio-records, interviews with clients and professionals shortly and 3–6 months after the consultation and questionnaires to collect background information. The data were analysed by deductive content analysis. Findings: Constructive engagement was visible in all consultations. Clients and professionals showed respect, empathy and curiosity towards each other. In most consultations, two or more alternative actions are recognised and discussed. Comparative learning appears to be two sided, the client and the professional learn from each other's knowledge and experiences. Construction and elicitation of preference, and preference integration, seems to be present, but difficult to recognise in all consultations. Discussion/conclusion: Although all propositions could be identified, there seems room for improvement in preference elicitation and integration of these preferences in the discussions on courses of action. Assistance seems needed with preference elicitation, both for the clients and for the professional.
KW - collaborative deliberation
KW - consultations
KW - long-term care
KW - patient preferences
KW - professional–patient relationship
KW - Shared decision-making
U2 - 10.1177/14777509211036647
DO - 10.1177/14777509211036647
M3 - Article
SN - 1477-7509
VL - 17
SP - 297
EP - 310
JO - Clinical Ethics
JF - Clinical Ethics
IS - 3
ER -