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A qualitative study of professional and client perspectives on information flows and decision aid use

机译：对信息流和决策辅助使用的专业和客户观点的定性研究

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Background This paper explores the meanings given by a diverse range of stakeholders to a decision aid aimed at helping carers of people in early to moderate stages of dementia (PWD) to select community based respite services. Decision aids aim to empower clients to share decision making with health professionals. However, the match between health professionals' perspectives on decision support needs and their clients' perspective is an important and often unstudied aspect of decision aid use. Methods A secondary analysis was undertaken of qualitative data collected as part of a larger study. The data included twelve interviews with carers of people with dementia, three interviews with expert advisors, and three focus groups with health professionals. A theoretical analysis was conducted, drawing on theories of 'positioning' and professional identity. Results Health professionals are seen to hold varying attitudes and beliefs about carers' decision support needs, and these appeared to be grounded in the professional identity of each group. These attitudes and beliefs shaped their attitudes towards decision aids, the information they believed should be offered to dementia carers, and the timing of its offering. Some groups understood carers as needing to be protected from realistic information and consequently saw a need to filter information to carer clients. Conclusion Health professionals' beliefs may cause them to restrict information flows, which can limit carers' ability to make decisions, and limit health services' ability to improve partnering and shared decision making. In an era where information is freely available to those with the resources to access it, we question whether health professionals should filter information.
机译：背景技术本文探讨了各种利益相关者对决策援助的意义，该决策援助旨在帮助痴呆症早期至中度阶段（PWD）的护理人员选择基于社区的暂息服务。决策辅助旨在使客户能够与卫生专业人员共享决策。但是，卫生专业人员对决策支持需求的看法与他们的客户的看法之间的匹配是决策援助使用的一个重要且经常未被研究的方面。方法对大规模研究中收集的定性数据进行了二次分析。数据包括对痴呆症患者护理者的十二次采访，对专家顾问的三次采访以及对卫生专业人员的三个焦点小组。根据“定位”和职业认同的理论进行了理论分析。结果人们发现卫生专业人员对护理人员的决策支持需求持有不同的态度和信念，这些态度和信念似乎是基于每个小组的专业身份。这些态度和信念塑造了他们对决策辅助的态度，他们认为应该提供给痴呆症照护者的信息以及提供时机的态度。一些团体将照顾者理解为需要免受现实信息的侵害，因此认为有必要将信息过滤给照顾者客户。结论卫生专业人员的信念可能导致他们限制信息流，这可能会限制护理人员的决策能力，并限制卫生服务机构改善合作和共享决策的能力。在一个信息可供拥有资源的人免费获得的时代，我们质疑卫生专业人员是否应过滤信息。

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