96 Chapter 6 Abstract Objectives This study utilizes the Diffusion of Innovations (DOI) theory to comprehensively understand the adoption of Shared Decision-Making (SDM) in clinical practice, specifically focusing on the ‘knowledge’ and ‘persuasion’ stages within DOI. We aim to understand the challenges and dynamics associated with SDM adoption, offering insights for more patient-centered decision-making in healthcare. Design This qualitative study employs a modified framework analysis approach, integrating ethnographic and interview data from prior research, along with additional interviews. The framework used is based on DOI theory. Study setting and participants This study was conducted in the obstetrics and gynecology department of a tertiary teaching hospital in the Eastern region of the Netherlands. It included interviews with twenty participants, including gynecologists, residents, and junior doctors currently practicing in the department. Additionally, data from prior research conducted within the same department were incorporated, ensuring the maintenance of contextual consistency. Results Findings reveal a complex interplay between SDM’s benefits and challenges. Clinicians value SDM for upholding patient autonomy and enhancing medical practice, viewing it as valuable for medical decision-making. Decision aids are seen as advantageous in supporting treatment decisions. Challenges include perceptions of SDM as time-consuming and difficult, compatibility issues between patient and clinician preferences, and constraints due to healthcare’s pace. Additionally, perceived complexity varies by situation, influenced by colleagues’ attitudes, with limited trialability and sparsely observed instances of SDM. Conclusions Clinicians’ decision to adopt or reject SDM is multifaceted, shaped by beliefs, cognitive processes, and contextual challenges. Cognitive dissonance is critical as clinicians reconcile their existing practices with the adoption of SDM. To promote SDM adoption, practical strategies like practice assessments, open discussions about SDM’s utility, and encouraging reflective practice through professional development initiatives should be employed.
RkJQdWJsaXNoZXIy MTk4NDMw