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Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review

BACKGROUND: Decision coaching is non-directive support delivered by a trained healthcare provider to help people prepare to actively participate in making healthcare decisions. This study aimed to understand how and under what circumstances decision coaching works for people making healthcare decisi...

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Autores principales: Zhao, Junqiang, Jull, Janet, Finderup, Jeanette, Smith, Maureen, Kienlin, Simone Maria, Rahn, Anne Christin, Dunn, Sandra, Aoki, Yumi, Brown, Leanne, Harvey, Gillian, Stacey, Dawn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9548102/
https://www.ncbi.nlm.nih.gov/pubmed/36209086
http://dx.doi.org/10.1186/s12911-022-02007-0
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author Zhao, Junqiang
Jull, Janet
Finderup, Jeanette
Smith, Maureen
Kienlin, Simone Maria
Rahn, Anne Christin
Dunn, Sandra
Aoki, Yumi
Brown, Leanne
Harvey, Gillian
Stacey, Dawn
author_facet Zhao, Junqiang
Jull, Janet
Finderup, Jeanette
Smith, Maureen
Kienlin, Simone Maria
Rahn, Anne Christin
Dunn, Sandra
Aoki, Yumi
Brown, Leanne
Harvey, Gillian
Stacey, Dawn
author_sort Zhao, Junqiang
collection PubMed
description BACKGROUND: Decision coaching is non-directive support delivered by a trained healthcare provider to help people prepare to actively participate in making healthcare decisions. This study aimed to understand how and under what circumstances decision coaching works for people making healthcare decisions. METHODS: We followed the realist review methodology for this study. This study was built on a Cochrane systematic review of the effectiveness of decision coaching interventions for people facing healthcare decisions. It involved six iterative steps: (1) develop the initial program theory; (2) search for evidence; (3) select, appraise, and prioritize studies; (4) extract and organize data; (5) synthesize evidence; and (6) consult stakeholders and draw conclusions. RESULTS: We developed an initial program theory based on decision coaching theories and stakeholder feedback. Of the 2594 citations screened, we prioritized 27 papers for synthesis based on their relevance rating. To refine the program theory, we identified 12 context-mechanism-outcome (CMO) configurations. Essential mechanisms for decision coaching to be initiated include decision coaches’, patients’, and clinicians’ commitments to patients’ involvement in decision making and decision coaches’ knowledge and skills (four CMOs). CMOs during decision coaching are related to the patient (i.e., willing to confide, perceiving their decisional needs are recognized, acquiring knowledge, feeling supported), and the patient-decision coach interaction (i.e., exchanging information, sharing a common understanding of patient’s values) (five CMOs). After decision coaching, the patient’s progress in making or implementing a values-based preferred decision can be facilitated by the decision coach’s advocacy for the patient, and the patient’s deliberation upon options (two CMOs). Leadership support enables decision coaches to have access to essential resources to fulfill their role (one CMOs). DISCUSSION: In the refined program theory, decision coaching works when there is strong leadership support and commitment from decision coaches, clinicians, and patients. Decision coaches need to be capable in coaching, encourage patients’ participation, build a trusting relationship with patients, and act as a liaison between patients and clinicians to facilitate patients’ progress in making or implementing an informed values-based preferred option. More empirical studies, especially qualitative and process evaluation studies, are needed to further refine the program theory. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-022-02007-0.
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spelling pubmed-95481022022-10-10 Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review Zhao, Junqiang Jull, Janet Finderup, Jeanette Smith, Maureen Kienlin, Simone Maria Rahn, Anne Christin Dunn, Sandra Aoki, Yumi Brown, Leanne Harvey, Gillian Stacey, Dawn BMC Med Inform Decis Mak Research BACKGROUND: Decision coaching is non-directive support delivered by a trained healthcare provider to help people prepare to actively participate in making healthcare decisions. This study aimed to understand how and under what circumstances decision coaching works for people making healthcare decisions. METHODS: We followed the realist review methodology for this study. This study was built on a Cochrane systematic review of the effectiveness of decision coaching interventions for people facing healthcare decisions. It involved six iterative steps: (1) develop the initial program theory; (2) search for evidence; (3) select, appraise, and prioritize studies; (4) extract and organize data; (5) synthesize evidence; and (6) consult stakeholders and draw conclusions. RESULTS: We developed an initial program theory based on decision coaching theories and stakeholder feedback. Of the 2594 citations screened, we prioritized 27 papers for synthesis based on their relevance rating. To refine the program theory, we identified 12 context-mechanism-outcome (CMO) configurations. Essential mechanisms for decision coaching to be initiated include decision coaches’, patients’, and clinicians’ commitments to patients’ involvement in decision making and decision coaches’ knowledge and skills (four CMOs). CMOs during decision coaching are related to the patient (i.e., willing to confide, perceiving their decisional needs are recognized, acquiring knowledge, feeling supported), and the patient-decision coach interaction (i.e., exchanging information, sharing a common understanding of patient’s values) (five CMOs). After decision coaching, the patient’s progress in making or implementing a values-based preferred decision can be facilitated by the decision coach’s advocacy for the patient, and the patient’s deliberation upon options (two CMOs). Leadership support enables decision coaches to have access to essential resources to fulfill their role (one CMOs). DISCUSSION: In the refined program theory, decision coaching works when there is strong leadership support and commitment from decision coaches, clinicians, and patients. Decision coaches need to be capable in coaching, encourage patients’ participation, build a trusting relationship with patients, and act as a liaison between patients and clinicians to facilitate patients’ progress in making or implementing an informed values-based preferred option. More empirical studies, especially qualitative and process evaluation studies, are needed to further refine the program theory. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-022-02007-0. BioMed Central 2022-10-08 /pmc/articles/PMC9548102/ /pubmed/36209086 http://dx.doi.org/10.1186/s12911-022-02007-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhao, Junqiang
Jull, Janet
Finderup, Jeanette
Smith, Maureen
Kienlin, Simone Maria
Rahn, Anne Christin
Dunn, Sandra
Aoki, Yumi
Brown, Leanne
Harvey, Gillian
Stacey, Dawn
Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
title Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
title_full Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
title_fullStr Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
title_full_unstemmed Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
title_short Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
title_sort understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9548102/
https://www.ncbi.nlm.nih.gov/pubmed/36209086
http://dx.doi.org/10.1186/s12911-022-02007-0
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