109 Applying a DOI theory-based framework not solely focus on straightforward situations. They should also address challenging scenarios where practitioners commonly decide against SDM due to how they resolve their dissonant beliefs. Understanding the arguments used and facilitating open-minded discussions weighing these arguments is once again crucial in the decision to either adopt or reject the use of SDM. This need for facilitated reflections becomes even more apparent when considering more experienced professionals. Reflective practice and subsequent practice change tend to decline with increased experience, necessitating additional efforts to facilitate reflections among more experienced practitioners. [44] Particularly in these cases, advocating solely for SDM as the best approach is unlikely to yield positive results. Instead, concerted efforts should be made to challenge prevailing beliefs and practice routines, maintaining an open attitude towards potential flaws in the SDM approach in certain situations. Ultimately, regardless of external or cultural influences, the individual professional possesses the agency to either adopt or reject SDM. [45, 46] Therefore, addressing these individuals most effectively is essential. Our study acknowledges several limitations. One limitation is related to the framework analysis approach, which inherently risks construction and interpretation being influenced by the researchers’ preconceptions and assumptions. The authors took proactive measures to mitigate this bias by critically reflecting on our backgrounds. Additionally, we employed an existing framework, namely DOI theory, to guide our data analysis, which provided a structured and theoretically grounded approach. Another limitation common to qualitative research is the challenge of generalizability. While our study was conducted in a specific healthcare setting, caution should be exercised when extrapolating the results to other healthcare contexts. However, we addressed this limitation by drawing upon well-established psychological theories when formulating our more broadly relevant recommendations. Finally, our study centered on the role of clinicians within SDM, overlooking patient perspectives within this collaborative process. This decision was driven by the recognition that, in the end, clinicians often determine whether SDM is used or not. Conclusion Adopting or rejecting Shared Decision Making (SDM) is a complex process influenced by beliefs, cognitions, and contextual challenges. Our DOI-based framework analysis aids in identifying these influential factors. Cognitive dissonance plays a significant role as clinicians seek justifications for their current practices or for embracing SDM. By employing strategies such as practice assessments, fostering open discussions on the usefulness of SDM, and promoting reflective practice in, for example, continuing professional development initiatives, we can empower individual clinicians to make the best choices regarding the adoption of SDM. Future research should focus on understanding the cognitive and behavioral factors influencing SDM adoption and developing evidence-based strategies to empower informed decisionmaking in embracing SDM practices. 6
RkJQdWJsaXNoZXIy MTk4NDMw