TY - JOUR
T1 - Shared challenges and opportunities
T2 - Uncovering common ground in patient participation across different healthcare settings and patient groups. A qualitative meta-summary on patient-reported barriers and facilitators to participation in shared decision-making
AU - Mertens, L.
AU - Kasmi, T.
AU - Bekkering, G. E.
AU - Hannes, K.
AU - Vermandere, M.
AU - Delvaux, N.
AU - Van Bostraeten, P.
AU - Jaeken, J.
AU - van der Weijden, T.
AU - Rademakers, J.
AU - Aertgeerts, B.
N1 - Funding Information:
This research received a grant from the \u2018Constant Van de Wiel \u2013 Joanna Mathues Fund\u2019 of the Faculty of Medicine of the Catholic University of Leuven (KU Leuven), Belgium.
Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Objective: We aim to provide an updated literature overview on patient-reported barriers and facilitators to participation in SDM across different patient groups and healthcare settings to uncover the ‘common ground’ and to reach for a more generalizable, uniform and inclusive insight in patients’ perspective on participation in SDM. Methodology: We conducted a qualitative meta-summary, using five databases. Search terms were based on the concepts: ‘decision-making’, ‘patient participation’, ‘patient perceptions’ and ‘study design’ (of patient reporting). Results: We found 9265 unique references, selected 209 studies for further sampling and finally withheld 90 studies for further analysis in this review. In total, we identified 34 different barriers and facilitators. Based on most frequently reported barriers and facilitators, we defined four broad analytical themes corresponding to patients’ shared expectations concerning doctors’, patients’ and others’ facilitative roles in SDM: (1) ‘Doctors explaining well’, (2) ‘Doctors listening well, and fostering a trusting relationship’, (3) ‘Patients being assertive, (4) ‘Patients being socially supported’. Conclusion: The majority of barriers and facilitators we found transcended differences in patient characteristics or healthcare setting, suggesting that patients are, overall, facing shared challenges and opportunities in SDM, that are mostly generalizable and irrespective of variabilities in decisional setting or patient group. We uncovered new trends such as patients’ growing openness to assertiveness and the involvement of significant others, and highlighted some culture-based nuances, compared to earlier literature. Practice Implications: These new insights need to be integrated in SDM strategies so that they may serve the ethical imperative of a greater equality and inclusion of diverse patient groups in different SDM settings.
AB - Objective: We aim to provide an updated literature overview on patient-reported barriers and facilitators to participation in SDM across different patient groups and healthcare settings to uncover the ‘common ground’ and to reach for a more generalizable, uniform and inclusive insight in patients’ perspective on participation in SDM. Methodology: We conducted a qualitative meta-summary, using five databases. Search terms were based on the concepts: ‘decision-making’, ‘patient participation’, ‘patient perceptions’ and ‘study design’ (of patient reporting). Results: We found 9265 unique references, selected 209 studies for further sampling and finally withheld 90 studies for further analysis in this review. In total, we identified 34 different barriers and facilitators. Based on most frequently reported barriers and facilitators, we defined four broad analytical themes corresponding to patients’ shared expectations concerning doctors’, patients’ and others’ facilitative roles in SDM: (1) ‘Doctors explaining well’, (2) ‘Doctors listening well, and fostering a trusting relationship’, (3) ‘Patients being assertive, (4) ‘Patients being socially supported’. Conclusion: The majority of barriers and facilitators we found transcended differences in patient characteristics or healthcare setting, suggesting that patients are, overall, facing shared challenges and opportunities in SDM, that are mostly generalizable and irrespective of variabilities in decisional setting or patient group. We uncovered new trends such as patients’ growing openness to assertiveness and the involvement of significant others, and highlighted some culture-based nuances, compared to earlier literature. Practice Implications: These new insights need to be integrated in SDM strategies so that they may serve the ethical imperative of a greater equality and inclusion of diverse patient groups in different SDM settings.
KW - Patient participation
KW - Patient perspective
KW - Patient-reported barriers/facilitators
KW - Shared decision making
U2 - 10.1016/j.pec.2024.108475
DO - 10.1016/j.pec.2024.108475
M3 - (Systematic) Review article
SN - 0738-3991
VL - 130
JO - Patient Education and Counseling
JF - Patient Education and Counseling
M1 - 108475
ER -