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Engaging in patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis: the views of health professionals

Citation

Hogden, A and Greenfield, D and Nugus, P and Kiernan, M, Engaging in patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis: the views of health professionals, Patient Preference and Adherence, 6, (5) pp. 691-701. ISSN 1177-889X (2012) [Refereed Article]


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Copyright 2012 Hogden et al. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0) https://creativecommons.org/licenses/by-nc/3.0/

DOI: doi:10.2147/PPA.S36759

Abstract

Background: The aim of this study was to explore clinician perspectives on patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis (ALS), in an attempt to identify factors influencing decision-making. Methods: Thirty-two health professionals from two specialized multidisciplinary ALS clinics participated in individual and group interviews. Participants came from allied health, medical, and nursing backgrounds. Interviews were audio recorded, and the transcripts were analyzed thematically. Results: Respondents identified barriers and facilitators to optimal timing and quality of decision-making. Barriers related to the patient and the health system. Patient barriers included difficulties accepting the diagnosis, information sources, and the patient-carer relationship. System barriers were timing of diagnosis and symptom management services, access to ALS-specific resources, and interprofessional communication. Facilitators were teamwork approaches, supported by effective communication and evidence-based information. Conclusion: Patient-centered and collaborative decision-making is influenced by a range of factors that inhibit the delivery of optimal care. Decision-making relies on a fine balance between timing of information and service provision, and the readiness of patients to receive them. Health system restrictions impacted on optimal timing, and patients coming to terms with their condition. Clinicians valued proactive decision-making to prepare patients and families for inevitable change. The findings indicate disparity between patient choices and clinician perceptions of evidence, knowledge, and experience. To improve multidisciplinary ALS practice, and ultimately patient care, further work is required to bridge this gap in perspectives.

Item Details

Item Type:Refereed Article
Keywords:patient decision-making, multidisciplinary care, amyotrophic lateral sclerosis, barriers and facilitators, health professional perceptions
Research Division:Medical and Health Sciences
Research Group:Other Medical and Health Sciences
Research Field:Medical and Health Sciences not elsewhere classified
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health and Support Services not elsewhere classified
Author:Greenfield, D (Professor David Greenfield)
ID Code:110969
Year Published:2012
Web of Science® Times Cited:14
Deposited By:Tasmanian School of Business and Economics
Deposited On:2016-08-24
Last Modified:2017-11-03
Downloads:55 View Download Statistics

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