108 Chapter 6 which lack SDM. This discomfort can compel them to seek justifications for their existing approaches. For example, they may cite time constraints or difficulties in implementing SDM for patients with low health literacy as good reasons for not executing SDM, as clinicians participating in our study mentioned as well. Additionally, clinicians may find reassurance in patient satisfaction with their current practices, which further discourages using SDM. Moreover, the preference for the status quo, commonly known as the status quo bias, reinforces these arguments against SDM adoption in certain situations. [34] Despite the potential adverse effects, cognitive dissonance can also serve as a powerful motivator for behavioral change, particularly when individuals hold conflicting solid beliefs. [35, 36] In our opinion, it is crucial to carefully address these dissonances to achieve practice change successfully. The following steps can aid in this process: First, it remains essential to identify professionals’ current cognitions and beliefs. A thorough understanding of the consonant and dissonant beliefs influencing professionals’ decisions to adopt or reject SDM is essential to address them effectively. Conducting practice assessments, similar to the approach used in our study, can be instrumental in uncovering these often covert beliefs. Secondly, there needs to be more open discussions surrounding these beliefs, particularly regarding the usefulness of SDM. While open communication within healthcare settings has been examined, mainly about professional or patient safety concerns and the importance of speaking up during incidents, [37, 38] research on open communication in other contexts remains relatively limited. [39] However, open communication is closely intertwined with significant, well-described psychological constructs, such as those outlined in Social Interdependence Theory. [40-42] This theory explores how individuals’ actions are influenced by their perceived interdependence, whether positive through cooperation towards shared goals or negative through competition and rivalry. [40] Contextual factors play a mediating role in determining whether interdependence is constructive. Mediating factors include valuing diverse perspectives, addressing emotions alongside factual information, and maintaining open-mindedness (p.109-110). [40] These findings align with a Dutch study highlighting the significance of an ‘open culture’ encompassing various aspects such as thoughts, emotions, attitudes, safety, and well-being. [39] These insights underscore the importance of openly discussing SDM beliefs and experiences. Through discussions with colleagues, making an informed argument to either adopt or reject SDM becomes possible. Thirdly, and in connection with the previous argumentation, fostering reflection is paramount. Reflective practice has long been recognized as an effective approach in continuous professional education, surpassing the limitations of simply prescribing or teaching new methods. [43] Through self-reflection, professionals critically evaluate their behaviors and decide whether to change or maintain them. Hence, openly addressing the cognitions and beliefs that hinder or promote the decision to adopt SDM is crucial. To foster behavioral change, training initiatives should
RkJQdWJsaXNoZXIy MTk4NDMw