Shared decision making in rural general practices:a qualitative exploration of older rural South Australians'perceived involvement in clinical consultations with doctors
10.1016/j.glohj.2024.08.003
- Author:
Hamiduzzaman MOHAMMAD
1
;
Siddiquee NOORE
;
Gaffney James HARRY
;
Barraclough FRANCES
;
Rahman AZIZ
;
Greenhill JENNENE
;
Flood VICKI
Author Information
1. University Centre for Rural Health(Northern Rivers),School of Health Sciences,Faculty of Medicine and Health,The University of Sydney,Lismore,New South Wales 2480,Australia
- Keywords:
General practices;
Shared decision making;
Older rural Australians;
Patient involvement;
South Australia
- From:
Global Health Journal
2024;8(3):140-146
- CountryChina
- Language:Chinese
-
Abstract:
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 implemen-tation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners pro-moting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.
