BMC Med Inform Decis Mak - Barriers and facilitators to implementing Decision Boxes in primary healthcare teams to facilitate shared decisionmaking: a study protocol.

Tópicos

{ decis(3086) make(1611) patient(1517) }
{ care(1570) inform(1187) nurs(1089) }
{ use(2086) technolog(871) perceiv(783) }
{ intervent(3218) particip(2042) group(1664) }
{ patient(1821) servic(1111) care(1106) }
{ state(1844) use(1261) util(961) }
{ data(3008) multipl(1320) sourc(1022) }
{ can(981) present(881) function(850) }
{ use(1733) differ(960) four(931) }
{ framework(1458) process(801) describ(734) }
{ learn(2355) train(1041) set(1003) }
{ studi(1410) differ(1259) use(1210) }
{ health(3367) inform(1360) care(1135) }
{ ehr(2073) health(1662) electron(1139) }
{ use(976) code(926) identifi(902) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ extract(1171) text(1153) clinic(932) }
{ method(984) reconstruct(947) comput(926) }
{ case(1353) use(1143) diagnosi(1136) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ monitor(1329) mobil(1314) devic(1160) }
{ medic(1828) order(1363) alert(1069) }
{ cost(1906) reduc(1198) effect(832) }
{ first(2504) two(1366) second(1323) }
{ health(1844) social(1437) communiti(874) }
{ high(1669) rate(1365) level(1280) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ model(3480) simul(1196) paramet(876) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Decision Boxes are summaries of the most important benefits and harms of health interventions provided to clinicians before they meet the patient, to prepare them to help patients make informed and value-based decisions. Our objective is to explore the barriers and facilitators to using Decision Boxes in clinical practice, more precisely factors stemming from (1) the Decision Boxes themselves, (2) the primary healthcare team (PHT), and (3) the primary care practice environment.METHODS/DESIGN: A two-phase mixed methods study will be conducted. Eight Decision Boxes relevant to primary care, and written in both English and in French, will be hosted on a website together with a tutorial to introduce the Decision Box. The Decision Boxes will be delivered as weekly emails over a span of eight weeks to clinicians of PHTs (family physicians, residents and nurses) in five primary care clinics located across two Canadian provinces. Using a web-questionnaire, clinicians will rate each Decision Box with the Information Assessment Method (cognitive impacts, relevance, usefulness, expected benefits) and with a questionnaire based on the Theory of Planned Behavior to study the determinants of clinicians' intention to use what they learned from that Decision Box in their patient encounter (attitude, social norm, perceived behavioral control). Web-log data will be used to monitor clinicians' access to the website. Following the 8-week intervention, we will conduct semi-structured group interviews with clinicians and individual interviews with clinic administrators to explore contextual factors influencing the use of the Decision Boxes. Data collected from questionnaires, focus groups and individual interviews will be combined to identify factors potentially influencing implementation of Decision Boxes in clinical practice by clinicians of PHTs.CONCLUSIONS: This project will allow tailoring of Decision Boxes and their delivery to overcome the specific barriers identified by clinicians of PHTs to improve the implementation of shared decision making in this setting.

Resumo Limpo

ckground decis box summari import benefit harm health intervent provid clinician meet patient prepar help patient make inform valuebas decis object explor barrier facilit use decis box clinic practic precis factor stem decis box primari healthcar team pht primari care practic environmentmethodsdesign twophas mix method studi will conduct eight decis box relev primari care written english french will host websit togeth tutori introduc decis box decis box will deliv week email span eight week clinician phts famili physician resid nurs five primari care clinic locat across two canadian provinc use webquestionnair clinician will rate decis box inform assess method cognit impact relev use expect benefit questionnair base theori plan behavior studi determin clinician intent use learn decis box patient encount attitud social norm perceiv behavior control weblog data will use monitor clinician access websit follow week intervent will conduct semistructur group interview clinician individu interview clinic administr explor contextu factor influenc use decis box data collect questionnair focus group individu interview will combin identifi factor potenti influenc implement decis box clinic practic clinician phtsconclus project will allow tailor decis box deliveri overcom specif barrier identifi clinician phts improv implement share decis make set

Resumos Similares

J. Med. Internet Res. - A web-based tool to support shared decision making for people with a psychotic disorder: randomized controlled trial and process evaluation. ( 0,858378444653385 )
Med Decis Making - What is known about parents' treatment decisions? A narrative review of pediatric decision making. ( 0,840633972586696 )
Med Decis Making - The impact of a novel computer-based decision aid on shared decision making for colorectal cancer screening: a randomized trial. ( 0,834080750713066 )
BMC Med Inform Decis Mak - Refining a brief decision aid in stable CAD: cognitive interviews. ( 0,826803565117218 )
BMC Med Inform Decis Mak - Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis. ( 0,825056978501962 )
Med Decis Making - Content coding for contextualization of care: evaluating physician performance at patient-centered decision making. ( 0,817850385181242 )
BMC Med Inform Decis Mak - Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform. ( 0,815708038019578 )
BMC Med Inform Decis Mak - Developing and user-testing Decision boxes to facilitate shared decision making in primary care--a study protocol. ( 0,813290768763049 )
Med Decis Making - Participation of very old adults in health care decisions. ( 0,805951228215907 )
BMC Med Inform Decis Mak - Development and initial evaluation of a treatment decision dashboard. ( 0,804199832223718 )
AMIA Annu Symp Proc - Supporting shared decision making within the MobiGuide project. ( 0,801177970186087 )
Med Decis Making - Framing Options as Choice or Opportunity: Does the Frame Influence Decisions? ( 0,799864363676907 )
BMC Med Inform Decis Mak - The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter. ( 0,799629539857567 )
BMC Med Inform Decis Mak - Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol. ( 0,798065668237764 )
Med Decis Making - Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery. ( 0,797806633515472 )
Healthc (Amst) - Incentivizing shared decision making in the USA--where are we now? ( 0,794779012419256 )
BMC Med Inform Decis Mak - Applying the theory of planned behaviour to multiple sclerosis patients' decisions on disease modifying therapy--questionnaire concept and validation. ( 0,793128342021797 )
Med Decis Making - Perceptions of shared decision making and decision aids among rural primary care clinicians. ( 0,790718134646059 )
BMC Med Inform Decis Mak - Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards. ( 0,789704728121223 )
AMIA Annu Symp Proc - Revisiting the EBM decision model to formalize non-compliance with computerized CPGs: results in the management of breast cancer with OncoDoc2. ( 0,78851684920496 )
BMC Med Inform Decis Mak - Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis. ( 0,787822828138358 )
Med Decis Making - Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions. ( 0,787816803841498 )
Med Decis Making - Are medical outcomes fungible? A survey of voters, medical administrators, and physicians. ( 0,787277813696228 )
Med Decis Making - All stories are not alike: a purpose-, content-, and valence-based taxonomy of patient narratives in decision aids. ( 0,779079586446728 )
Med Decis Making - When decisions should be shared: a study of social norms in medical decision making using a factorial survey approach. ( 0,776943366554217 )
BMC Med Inform Decis Mak - Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence. ( 0,776318610357567 )
BMC Med Inform Decis Mak - Development of a tool to improve the quality of decision making in atrial fibrillation. ( 0,776124780513294 )
BMC Med Inform Decis Mak - Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer. ( 0,775735968446605 )
BMC Med Inform Decis Mak - Clarifying values: an updated review. ( 0,774136224518381 )
Med Decis Making - Factors Associated with Informed Decisions and Participation in Bowel Cancer Screening among Adults with Lower Education and Literacy. ( 0,772113889070387 )
Med Decis Making - Preferences and perceived involvement in treatment decision making among Chinese patients with chronic hepatitis. ( 0,770198022909622 )
BMC Med Inform Decis Mak - Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature. ( 0,768794256301679 )
AMIA Annu Symp Proc - An information-centric framework for designing patient-centered medical decision aids and risk communication. ( 0,768004456529456 )
Med Decis Making - Adherence and decision AIDS: a model and a narrative review. ( 0,767970644019659 )
J. Med. Internet Res. - Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. ( 0,762353706965723 )
BMC Med Inform Decis Mak - Decision aids for respite service choices by carers of people with dementia: development and pilot RCT. ( 0,758114745048507 )
BMC Med Inform Decis Mak - Development and pilot testing of a decision aid for drivers with dementia. ( 0,748751835673198 )
Med Decis Making - Why do patients derogate physicians who use a computer-based diagnostic support system? ( 0,748283929937629 )
Med Decis Making - Breast cancer patients' treatment expectations after exposure to the decision aid program adjuvant online: the influence of numeracy. ( 0,746259500110176 )
BMC Med Inform Decis Mak - Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions. ( 0,743179222013226 )
BMC Med Inform Decis Mak - Arriba-lib: evaluation of an electronic library of decision aids in primary care physicians. ( 0,741567473047606 )
J Biomed Inform - Opportunistic decision making and complexity in emergency care. ( 0,740253330424575 )
J. Med. Internet Res. - The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study. ( 0,731955818024132 )
BMC Med Inform Decis Mak - The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial. ( 0,728439557941472 )
J Med Syst - The reliability of an epilepsy treatment clinical decision support system. ( 0,724027743981444 )
BMC Med Inform Decis Mak - Data mining of audiology patient records: factors influencing the choice of hearing aid type. ( 0,723986541371311 )
Med Decis Making - Decision coaching to prepare patients for making health decisions: a systematic review of decision coaching in trials of patient decision AIDS. ( 0,716570993514472 )
BMC Med Inform Decis Mak - Shared decision-making and health for First Nations, M?tis and Inuit women: a study protocol. ( 0,716027101991967 )
Med Decis Making - The context of available options affects health care decisions: a generalization study. ( 0,714161347839925 )
Med Decis Making - The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. ( 0,71389730440692 )
Int J Med Inform - Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation. ( 0,709639906375181 )
J. Med. Internet Res. - Perceived barriers and facilitators of using a Web-based interactive decision aid for colorectal cancer screening in community practice settings: findings from focus groups with primary care clinicians and medical office staff. ( 0,705242411276918 )
BMC Med Inform Decis Mak - Development and pilot testing of an online case-based approach to shared decision making skills training for clinicians. ( 0,700945664300431 )
Med Decis Making - Theoretical foundation of patient v. population preferences in calculating QALYs. ( 0,698317313435836 )
Int J Med Inform - Pharmacist-conducted medication reconciliation at hospital admission using information technology in Taiwan. ( 0,698043250853829 )
Med Decis Making - Decision aid influences on factors associated with patient empowerment prior to cancer treatment decision making. ( 0,695316461546969 )
BMC Med Inform Decis Mak - A randomized study of telephonic care support in populations at risk for musculoskeletal preference-sensitive surgeries. ( 0,692976644502976 )
BMC Med Inform Decis Mak - Disclosing conflicts of interest in patient decision aids. ( 0,691772886772454 )
Med Decis Making - The impact of explicit values clarification exercises in a patient decision aid emerges after the decision is actually made: evidence from a randomized controlled trial. ( 0,690773009044312 )
Med Decis Making - What makes a tumor diagnosis a call to action? On the preference for action versus inaction. ( 0,69067570876228 )
BMC Med Inform Decis Mak - A qualitative study of professional and client perspectives on information flows and decision aid use. ( 0,688160620628506 )
Med Decis Making - An emerging field of research: challenges in pediatric decision making. ( 0,683086993581786 )
BMC Med Inform Decis Mak - Diagnosis and management of people with venous thromboembolism and advanced cancer: how do doctors decide? A qualitative study. ( 0,675452627356203 )
Med Decis Making - Choice set size and decision making: the case of Medicare Part D prescription drug plans. ( 0,671391799832541 )
BMC Med Inform Decis Mak - Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data. ( 0,66513656332248 )
BMC Med Inform Decis Mak - Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy. ( 0,664965760425409 )
Med Decis Making - A model to support shared decision making in electronic health records systems. ( 0,664644779781615 )
IEEE J Biomed Health Inform - Leveraging social supports for improving personal expertise on ACL reconstruction and rehabilitation. ( 0,663876588783726 )
AMIA Annu Symp Proc - Patient clinical profiles associated with physician non-compliance despite the use of a guideline-based decision support system: a case study with OncoDoc2 using data mining techniques. ( 0,6611925997161 )
Artif Intell Med - From decision to shared-decision: Introducing patients' preferences into clinical decision analysis. ( 0,661062762887967 )
Int J Med Inform - Model development for EHR interdisciplinary information exchange of ICU common goals. ( 0,660419704369946 )
J. Med. Internet Res. - Acceptability and preliminary feasibility of an internet/CD-ROM-based education and decision program for early-stage prostate cancer patients: randomized pilot study. ( 0,659145012030995 )
Int J Med Inform - Designing for collaborative interpretation in telemonitoring: re-introducing patients as diagnostic agents. ( 0,659070851601192 )
Comput Methods Programs Biomed - AngioLab--a software tool for morphological analysis and endovascular treatment planning of intracranial aneurysms. ( 0,655916276210269 )
J Med Syst - Designing an architectural style for dynamic medical Cross-Organizational Workflow management system: an approach based on agents and web services. ( 0,655273329179901 )
J Am Med Inform Assoc - Imaging informatics for consumer health: towards a radiology patient portal. ( 0,655151894750932 )
BMC Med Inform Decis Mak - Do personal stories make patient decision aids more effective? A critical review of theory and evidence. ( 0,650395031255939 )
BMC Med Inform Decis Mak - Values clarification in a decision aid about fertility preservation: does it add to information provision? ( 0,646734578311021 )
Med Decis Making - Cost-effectiveness on a local level: whether and when to adopt a new technology. ( 0,645330656036042 )
Comput Methods Programs Biomed - Implementation and evaluation of an Asbru-based decision support system for adjuvant treatment in breast cancer. ( 0,644579322092077 )
J Med Syst - VIKOR method with enhanced accuracy for multiple criteria decision making in healthcare management. ( 0,641846950931216 )
J Am Med Inform Assoc - Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary. ( 0,641620225621699 )
J. Med. Internet Res. - Development and evaluation of the personal patient profile-prostate (P3P), a Web-based decision support system for men newly diagnosed with localized prostate cancer. ( 0,637943156886373 )
J Am Med Inform Assoc - A clinical decision support needs assessment of community-based physicians. ( 0,637708643737125 )
BMC Med Inform Decis Mak - Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas. ( 0,637441971910805 )
BMC Med Inform Decis Mak - Incorporating patient and family preferences into evidence-based medicine. ( 0,637255646239305 )
BMC Med Inform Decis Mak - Many miles to go ?: a systematic review of the implementation of patient decision support interventions into routine clinical practice. ( 0,636348385953309 )
J Am Med Inform Assoc - Triaging patients at risk of influenza using a patient portal. ( 0,635864161045124 )
Med Decis Making - Where is the evidence? A systematic review of shared decision making and patient outcomes. ( 0,635426786902688 )
J Med Syst - Development of a decision support engine to assist patients with hospital selection. ( 0,633464965292765 )
J Med Syst - Comparison of AI techniques for prediction of liver fibrosis in hepatitis patients. ( 0,62904342192889 )
BMC Med Inform Decis Mak - The influence of medical testing on patients' health: an overview from the gynecologists' perspective. ( 0,626397998862787 )
BMC Med Inform Decis Mak - A preliminary exploration of the feasibility of offering men information about potential prostate cancer treatment options before they know their biopsy results. ( 0,623682147934646 )
BMC Med Inform Decis Mak - User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner. ( 0,62338439272593 )
Comput Methods Programs Biomed - S-PC: an e-treatment application for management of smoke-quitting patients. ( 0,621517615708991 )
J Am Med Inform Assoc - Patient-initiated electronic health record amendment requests. ( 0,616179272709339 )
BMC Med Inform Decis Mak - Intention to adopt clinical decision support systems in a developing country: effect of physician's perceived professional autonomy, involvement and belief: a cross-sectional study. ( 0,614538089188043 )
Med Decis Making - Can Streamlined Multicriteria Decision Analysis Be Used to Implement Shared Decision Making for Colorectal Cancer Screening? ( 0,614516091785333 )
Int J Health Geogr - Mass casualty modelling: a spatial tool to support triage decision making. ( 0,61448237285021 )
J. Med. Internet Res. - Cool but counterproductive: interactive, Web-based risk communications can backfire. ( 0,61219757744507 )