81 Studying physician-related attributes of SDM Introduction Over the past two decades, shared decision-making (SDM) has emerged as a prominent approach in healthcare, advocating for collaborative decision-making between healthcare providers and patients. It involves doctors and patients sharing the best available evidence, engaging in meaningful discussions about treatment options, and ultimately reaching a consensus based on the patient’s values, preferences, and unique clinical circumstances. [1] SDM is considered an essential additional component of evidence-based medicine, enriching decision-making by actively involving patients in their healthcare choices. [2, 3] Research suggests that SDM can lead to better patient understanding of available options, improved perception of potential benefits and risks, and ultimately, decisions that better align with patients’ values and preferences. [4, 5] Although promising as a concept and despite supportive measures like decision aids and training in decision-making, implementing SDM has been a laborious, challenging, and time-consuming process. [6-8] Moreover, SDM utilization is perceived as incomplete or inconclusive, [9-11] even though advice on overcoming obstacles for successful implementation seems readily available. [8, 12, 13] Therefore, whether previous studies on (surmounting) barriers to implementation have considered all crucial determinants for success remains to be debated. A recent review on barriers to SDM implementation could be helpful, as it considers those barriers from a slightly different perspective. It stratifies obstacles according to the system, provider, and patient levels, with most challenges occurring at the provider level. [14] Therefore, it might be imperative to consider those provider-level barriers in particular. One relevant perspective for investigating provider-level barriers is Everett Rogers’ Diffusion of Innovations (DOI) theory. As an influential author in the change management literature, Rogers extensively explores the spread of new ideas and technologies, also known as ‘innovations’, and how attributes such as complexity can influence their successful adoption by individual users. [15] Complexity, in the context of DOI, refers to the perceived difficulty experienced by users in understanding or using an innovation. [15] Rogers contends that an innovation’s complexity is negatively related to its adoption rate, making it a pertinent attribute to examine in the context of SDM. However, predicting the perceived difficulty of SDM in healthcare is challenging due to the multitude of factors influencing healthcare encounters. Lorenzetti et al. highlight that challenging encounters can be attributed to various factors associated with physicians, patients, situational context, or a combination of these. [16] Additionally, Self-Determination Theory (SDT), a renowned psychological theory, posits that perceived difficulty is interdependently related to an individual’s sense of autonomy and competence. [17] If an individual perceives a task as overly challenging or beyond their perceived competence levels, they may experience greater difficulty and reduced motivation or satisfaction. [17] 5
RkJQdWJsaXNoZXIy MTk4NDMw