Abstract：
BACKGROUND: Shared decision making (SDM) has become a crucial element on the political agenda and represents a vital aspect of modern healthcare. However, successful implementation of SDM highly depends on the attitude of clinicians towards SDM. The overall aim of our study was to explore the experience of oncologists and nurses with SDM using the Decision Helper, an in-consultation decision aid, at four Danish radiotherapy departments.
METHODS: Semi-structured interviews were conducted with 20 clinicians. The participants were selected using purposive sampling to include nurses and oncologists, male and female, with different levels of experience with SDM and clinical work. The analysis was a data-driven, iterative process with inductive coding of all interviews and meaning condensation.
RESULTS: Two main themes emerged: \"Using the Decision Helper changes the consultation\" and \"Change of attitude among Danish oncologists.\" Each of the two themes included four elaborative subthemes, which are reported with supporting citations in this paper. In brief, the use of SDM and the Decision Helper should ideally be adjusted to the individual patient and depends highly on the oncologist. The participants described ambitions towards \"making the right decision for this patient at this time.\" The healthcare system, however, has pitfalls that may hinder SDM, e.g., rigid interpretation of guideline-based recommendations.
CONCLUSIONS: Using an in-consultation Decision Helper has the potential for individualized, structured patient engagement in decision making. There is a need for patient decision aids in clinical guidelines to ensure patient engagement in decision making.
METHODS: Semi-structured interviews were conducted with 20 clinicians. The participants were selected using purposive sampling to include nurses and oncologists, male and female, with different levels of experience with SDM and clinical work. The analysis was a data-driven, iterative process with inductive coding of all interviews and meaning condensation.
RESULTS: Two main themes emerged: \"Using the Decision Helper changes the consultation\" and \"Change of attitude among Danish oncologists.\" Each of the two themes included four elaborative subthemes, which are reported with supporting citations in this paper. In brief, the use of SDM and the Decision Helper should ideally be adjusted to the individual patient and depends highly on the oncologist. The participants described ambitions towards \"making the right decision for this patient at this time.\" The healthcare system, however, has pitfalls that may hinder SDM, e.g., rigid interpretation of guideline-based recommendations.
CONCLUSIONS: Using an in-consultation Decision Helper has the potential for individualized, structured patient engagement in decision making. There is a need for patient decision aids in clinical guidelines to ensure patient engagement in decision making.
摘要：
背景：共享决策（SDM）已成为政治议程上的关键要素，代表了现代医疗保健的重要方面。然而,SDM的成功实施在很大程度上取决于临床医生对SDM的态度。我们研究的总体目标是探索肿瘤学家和护士使用决策助手使用SDM的经验，协商中的决策援助，在丹麦的四个放射治疗部门。
方法：对20名临床医生进行了半结构化访谈。参与者是通过故意抽样选择的，包括护士和肿瘤学家，男性和女性，具有不同程度的SDM和临床工作经验。分析是数据驱动的，所有访谈的归纳编码和意义凝聚的迭代过程。
结果：出现了两个主要主题：“使用决策助手改变咨询”和“丹麦肿瘤学家态度的改变”。“这两个主题中的每一个都包括四个详尽的子主题，这在本文中有支持引用的报道。简而言之,理想情况下,SDM和决策助手的使用应根据患者个人情况进行调整,并高度依赖于肿瘤科医生.参与者描述了“此时为该患者做出正确决定”的雄心。“医疗系统，然而,有可能阻碍SDM的陷阱，例如，对基于指南的建议进行严格的解释。
结论：使用咨询决策助手具有个性化的潜力，结构化的患者参与决策。在临床指南中需要患者决策辅助以确保患者参与决策。
方法：对20名临床医生进行了半结构化访谈。参与者是通过故意抽样选择的，包括护士和肿瘤学家，男性和女性，具有不同程度的SDM和临床工作经验。分析是数据驱动的，所有访谈的归纳编码和意义凝聚的迭代过程。
结果：出现了两个主要主题：“使用决策助手改变咨询”和“丹麦肿瘤学家态度的改变”。“这两个主题中的每一个都包括四个详尽的子主题，这在本文中有支持引用的报道。简而言之,理想情况下,SDM和决策助手的使用应根据患者个人情况进行调整,并高度依赖于肿瘤科医生.参与者描述了“此时为该患者做出正确决定”的雄心。“医疗系统，然而,有可能阻碍SDM的陷阱，例如，对基于指南的建议进行严格的解释。
结论：使用咨询决策助手具有个性化的潜力，结构化的患者参与决策。在临床指南中需要患者决策辅助以确保患者参与决策。
