An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team
Open accessAbstract
BACKGROUND: Within the context of an exploratory case study, the authors assessed the perceptions of family caregivers about the decision-making process regarding relocating their relative and about the applicability of an interprofessional approach to shared decision making (IP-SDM). They also assessed perceptions of health professionals and health managers about IP-SDM. METHODS: From November 2010 to October 2011, we worked with one IP home care team dedicated to older adults (the case) from a large primary health care organization in Quebec City, Canada. We identified six of their clients who had faced a decision about whether to stay at home or move to a long-term care facility in the past year and interviewed their family caregivers. We explored the decision-making process they had experienced regarding relocating their relative and their perceptions about the applicability of IP-SDM in this context. Attitudes towards IP-SDM and potential barriers to this approach were explored using a focus group with the participating IP home care team, individual interviews with 8 managers and a survey of 272 health professionals from the primary care organization. A hybrid process of inductive and deductive thematic analysis was used and data were triangulated across all sources. RESULTS: Family caregivers reported lack of agreement on the nature of the decision to be made, a disconnection between home care services and relatives' needs, and high cost of long-term care alternatives. Factors influencing their decision included their ability to provide care for their relative. While they felt somewhat supported by the IP home care team, they also felt pressured in the decision. Overall, they did not perceive they had been exposed to IP-SDM but agreed that it was applicable in this context. Results from the survey, focus group and interviews with health professionals and managers indicated they all had a favourable attitude towards IP-SDM but many barriers hampered its implementation in their practice. CONCLUSIONS: The family caregivers in this study did not experience IP-SDM when relocating their relative. Added to results obtained with health professionals and managers, this highlights the need for an effective intervention targeting identified barriers to implementing IP-SDM in this context.
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The inability of clinicians, patients, and caregivers to predict each other's preferences is reported in the treatment decision making literature.
“The inability of clinicians, patients, and caregivers to predict each other’s preferences is also reported in the treatment decision making literature [7, 37–39].”
From Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design (2016) · cites this paper as [7]
The Discussion (page unavailable) says clinicians’ and family caregivers’ views about clients’ desired involvement in decisions may be flawed, and reports that clients’ preferences received little consideration. It does not establish that clinicians, patients, and caregivers are all unable to predict one another’s preferences. (LLM, conf=0.84)
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- Authors
- Légaré, F., Stacey, D., Brière, N., Robitaille, H., Lord, M.-C., Desroches, S., & Drolet, R.
- Affiliations
- Centre hospitalier universitaire de Québec (CA)
- University of Ottawa (CA)
- Centre de Santé et de Services Sociaux de la Vieille-Capitale (CA)
- Corresponding author
- Légaré, France
- Venue
- BMC Geriatrics
- Published
- 2014-07-02
- Volume
- 14
- Issue
- 1
- Pages
- 83-83
- ISSN
- 1471-2318 (ISSN-L)
- PMC
- PMC4105553
- OpenAlex
- W2089225235
- Cited by
- 58
- References
- 44
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 9 · 2021: 6 · 2020: 9 · 2019: 2 · 2018: 8 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 2
- FWCI
- 7.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Geriatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (213236)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- family caregivers, home care teams, older adults, caregiver decision-making, implementation barriers, clinician attitudes, primary care
- MeSH terms
- Aged, Aged, 80 and over, Decision Making, Female, Home Care Services, Humans, Interprofessional Relations, Middle Aged, Patient Care Team, Patient Participation, Caregivers
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