Shared decision making in rural general practices:a qualitative exploration of older rural South Australians'perceived involvement in clinical consultations with doctors  

作　　者：Mohammad Hamiduzzaman Noore Siddiquee Harry James Gaffney Frances Barraclough Aziz Rahman Jennene Greenhill Vicki Flood 

机构地区：[1]University Centrefor Rural Heath(Northern Rivers),Schoolof Health Sciences,Faculty of Medicine and Health,The University of Sydney,Lismore,New South Wales 2480,Australia [2]College of Government,Business and Law,Flinders University,Adelaide,South Australia 5042,Australia [3]Faculty of Medicine and Health,The University of Sydney,Sydney,New South Wales 2006,Australia [4]Institute of Health and Wellbeing,Federation University Australia,Ballarat,Victoria 3353,Australia [5]School of Nursing,Southern Cross University,Bilinga,Queensland 4225,Australia

出　　处：《Global Health Journal》2024年第3期140-146,共7页全球健康杂志（英文）

基　　金：financed by the Flinders University College of Business,Government and Law Large Project Grant(Grant number:100031.21).

摘　　要：Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.

关 键 词：General practices Shared decision making Olderrural Australians Patient involvement South Australia 

分 类 号：R19[医药卫生—卫生事业管理]