A qualitative study of physicians' perceptions of three decision aids

A qualitative study of physicians' perceptions of three decision aids
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DOI:
10.1016/s0738-3991(03)00050-8
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发表时间:
2003-07-01
影响因子:
3.5
通讯作者:
Tugwell, P
Tugwell, P
中科院分区:
医学2区
文献类型:
--
作者:
Graham, ID;Logan, J;Tugwell, P

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本研究旨在探讨医师对三种病患决策辅助工具(DA)的认知。对20名家庭医生和12名妇科医生进行了半结构化电话采访,询问考虑长期激素替代治疗的女性的DA;对16名呼吸科医生进行了关于严重慢性阻塞性肺疾病患者使用插管和机械通气的DA;并与19名医生(老年病学家,胃肠病学家,内科医生)就老年人长期放置饲管的DA进行了讨论。参与者是通过雪球抽样技术确定的。访谈采用标准的定性方法进行分析。大多数参与者(81%)表示愿意使用DA。积极看待发展议程的特点包括:平衡,组织良好,一个有用的工具,以证据为基础,改善决策过程和多媒体。一些负面特征被描述为:太复杂,成本,可用性,仅适用于某些患者群体,以及耗时。大多数与会者都接受了DAs。所有DA的感知积极和消极因素相似。如果医生有机会检查和试用决策辅助工具,如果他们可以不受限制地获得它们用于分发目的,则可能促进决策辅助工具的使用。(C)2003爱思唯尔科学爱尔兰有限公司保留所有权利。
The study objective was to investigate physicians' perceptions of three patient decision aids (DA). Semi-structured telephone interviews were conducted with 20 family physicians and 12 gynecologists about a DA for women considering long-term hormone replacement therapy; with 16 respirologists about a DA for the use of intubation and mechanical ventilation for patients with severe chronic obstructive pulmonary disease; and with 19 physicians (geriatricians, gastroenterologists, internists) about a DA for long-term placement of feeding tubes in the elderly. Participants were identified by a snowball sampling technique. The interviews were analyzed using standard qualitative methods. Most participants (81%) indicated some willingness to use the DAs. The characteristics of the DA viewed positively included it being: balanced, well organized, a useful tool, evidence-based, improves decision making process and multimedia. Some of the negative characteristics were stated as: too complex, the cost, the availability, only appropriate for certain groups of patients, and time consuming. The DAs were acceptable to most participants. Perceived positive and negative factors were similar for all DAs. Uptake of decision aids may be facilitated if physicians have an opportunity to examine and try them, and if they can have unfettered access to them for distribution purposes. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.