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315 Healthcare professionals’ perspective on participation and shared decision making among chronically ill children and their parents: an interview study
  1. David Zybarth,
  2. Maike Heiser,
  3. Laura Inhestern
  1. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

Abstract

Introduction There is evidence for positive effects of Shared Decision Making (SDM) and participation in healthcare processes on quality of care. In pediatrics, evidence is limited and the implementation of developed concepts of SDM remains inadequate. Chronically ill children and their parents are particularly affected, as their frequency of contact with various healthcare professionals (HCPs) is high. As part of the PedSDM study, we aimed to investigate the experiences and attitudes of HCPs towards SDM and participation.

Methods We conducted semi-structured interviews with HCPs of different disciplines (e.g. pediatricians, psychologists, physiotherapists). All participants had to work with chronically ill children. No further inclusion criteria were set. To achieve saturation of data, we aimed for 15–20 interviews. Participants were recruited in hospitals, rehabilitation clinics and social pediatric centers. Interviews are transcribed verbatim and analyzed using qualitative content analyses.

Results As the interviews are still ongoing, there are no final results yet. Final results will be presented at the conference. Preliminary results suggest that a lack of time is a major barrier for HCPs in implementing SDM and involving of children and parents in the healthcare process. HCPs’ understanding of SDM and involvement is based on personal beliefs rather than on conceptual ideas. Furthermore, parents are the main dialogue partners for most HCPs. Involving children into decision-making processes is perceived as challenging.

Discussion Participants recognize the importance of involving children and parents in the healthcare process. In the decision-making process in pediatrics, where parents decide on behalf of their child, it is challenging to balance all needs and expectations. The absence of adequate, clear and helpful guidelines exacerbates the situation.

Conclusion(s) To achieve successful implementation of SDM concepts and involvement of children and parents in healthcare processes, it is essential to consider the everyday work and perspective of the HCPs.

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