Journal
PATIENT EDUCATION AND COUNSELING
Volume 88, Issue 1, Pages 129-137Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2012.01.003
Keywords
Shared decision-making; Patient participation; Health professional patient-relationship; Complementary and alternative medicine; Health professional perspective; Qualitative research
Funding
- Karl and Veronica Carstens Foundation of Essen, Germany
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Objective: To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decision-making (SDM) from the health professional perspective. Methods: Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation. Results: The health professional-patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g. longer consultation time) and internal provider beliefs (e.g. attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM. Conclusion: Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM. Practice implications: Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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