Article - Legare: SDM examina key elements and barriers to adoption into practice
6 important questions on Article - Legare: SDM examina key elements and barriers to adoption into practice
According to this article: Shared decision making is most appropriately applied under conditions of ...
Uncertainty can arise when a decision is preference sensitive
- more than 1 option
- scientific evidence is absent or insufficient
- conflicting evidence without conclusion
Moreover, uncertainty arises at the level of individual decisions because probabilities of risks and benefits in a population as a whole cannot be directly applied to any given patient.
What are the 3 Essential Elements Of Shared Decision Making according to Legare?
- Recognizing The Need For A Decision
- pay-per-performance-regelingen --> minder keuzemogelijkheden bieden *
- Understanding the best available evidence
- denk aan moeilijk begrijpen getallen beide kanten -> beslis hulpmiddelen
- Incorporating patients' values and preferences
- waarden en voorkeuren pt kunnen instabiel zijn
- beslismoment, hulpmiddelen beschikbaar, organisatiecultuur creëren
* = This reality could partly explain why so many implementation trials of clinical practice guide- lines have shown that they have relatively little impact on actual practice.
What is said about 'time' in order to barriers for SDM?
Wij merken ook op dat ervaren tijdsdruk de meest genoemde barrière is voor elke verandering in de klinische praktijk. In die zin is het invoeren van gedeelde besluitvorming niet anders dan elke andere praktijkverbetering.
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What is said about 'patients' characteristics' in order to barriers for SDM?
What is said about 'clinical situations' in order to barriers for SDM?
= beleidsmatige belemmeringen
Waar ligt nu de moeilijkheidsgraad bij de patiënten als het gaat om SDM? According to Gillick
--> ipv pt te laten kiezen tussen chemo of radiotherapie vragen om zorgdroegen te verhelderen en artsen dat dan vertalen naar medisch handelingen
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