مجال التميز | تميز دراسي وبحثي |
البحوث المنشورة |
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البحث (1): | |
عنوان البحث: |
What Influences the Implementation of Shared Decision Making: An Umbrella Review |
رابط إلى البحث: |
https://www.sciencedirect.com/science/article/pii/S0738399120304365?via%3Dihub |
تاريخ النشر: |
11/08/2020 |
موجز عن البحث: |
Objective: To provide a cogent summation of the evidence base of the key barriers and facilitators to implementing shared decision making (SDM). Methods: An umbrella review of existing reviews on SDM was adopted. Databases were searched from 1997 to December 2018. Studies were included if they performed a review of barriers and facilitators to SDM. Results: 7 eligible reviews were identified. The five themes identified were: patient factors, professional factors, environmental factors, relationship factors, and factors related to information provision. Lack of time was the main factor hindering the implementation of SDM. Encouragement and motivation of providers to use SDM was a significant enabler of SDM implementation. Conclusions: The provision of time and resources are insufficient if not accompanied by efforts to support and motivate providers to use SDM. Practice implications: Healthcare providers need to be educated on the importance of building a relationship with their patients. To enhance this relationship, physicians may need to improve their interaction skills. They need to be curious and explore their patients’ preferences, listen to them and respect their opinions, explain options and outcomes, and encourage them to participate in the decision making. |
البحث (2): | |
عنوان البحث: |
Views of stakeholders on factors influencing shared decision-making in the Eastern Mediterranean Region: a systematic review |
رابط إلى البحث: |
https://applications.emro.who.int/emhj/v27/03/1020-3397-2021-2703-300-311-eng.pdf |
تاريخ النشر: |
27/03/2021 |
موجز عن البحث: |
Background: Shared decision-making is advocated as a key component of patient-centred care and associated with many benefits that improve patient outcomes. However, shared decision-making is not yet embedded in clinical practice and confronts many barriers that hinder its implementation especially in countries of the World Health Organization (WHO) Eastern Mediterranean Region. Aims: We conducted a systematic review to identify and understand factors influencing shared decision-making in the Region. Methods: We searched PsycINFO, CINAHL, PubMed, Medline, Scopus and Saudi Digital Library for articles published between January 1997 and February 2019. Studies conducted in the Region that reported barriers, facilitators, experiences, expectations and attitudes to shared decision-making were included. The Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of the studies in this review. Results: Of the 1813 initial articles retrieved, 19 eligible articles were identified. The main factors that emerged were grouped under three broad themes: participant factors (patients/families and physicians); consultation factors (relation- ship between participants, engaging patients, evaluating preferences, introducing options, providing information, and decision making); and healthcare system factors (organizational characteristics, time constraints, continuity of care, and healthcare resources). Conclusions: There is growing interest in shared decision-making in several countries in the Region. However, there are many existing barriers that hinder the implementation of shared decision-making. These need to be addressed before shared decision-making can be fully adopted in these countries. |
البحث (3): | |
عنوان البحث: |
Using a commercially available app for self-management of hypertension: Acceptance and usability study in Saudi Arabia |
رابط إلى البحث: | |
تاريخ النشر: |
09/02/2021 |
موجز عن البحث: |
Background: The use of smartphone apps to assist in the self-management of hypertension is becoming increasingly common, but few commercially available apps have the potential to be effective along with adequate security and privacy measures in place. In a previous study, we identified 5 apps that are potentially effective and safe, and based on the preferences of doctors and patients, one (Cora Health) was selected as the most suitable app for use in a Saudi context. However, there is currently no evidence of its usability and acceptance among potential users. Indeed, there has been little research into the usability and acceptance of hypertension apps in general, and less research considers this in the Gulf Region. Objective: This study aims to evaluate the acceptance and usability of the selected app in the Saudi context. Methods: This study used a mixed methods approach with 2 studies: a usability test involving patients in a controlled setting performing predefined tasks and a real-world usability study where patients used the app for 4 weeks. In the usability test, participants were asked to think aloud while performing the tasks, and an observer recorded the number of tasks they completed. At the end of the real-world pilot study, participants were interviewed, and the mHealth App Usability Questionnaire was completed. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used to analyze qualitative data. Results: In total, 10 patients completed study 1. The study found that app usability was moderate and that participants needed some familiarization time before they could use the app proficiently. Some usability issues were revealed, related to app accessibility and navigation, and a few tasks remained uncompleted by most people. A total of 20 patients completed study 2, with a mean age of 51.6 (SD 11.7) years. Study 2 found that the app was generally acceptable and easy to use, with some similar usability issues identified. Participants stressed the importance of practice and training to use it more easily and proficiently. Participants had a good engagement level with 48% retention at the end of study 2, with most participants’ engagement being classed as meaningful. The most recorded data were blood pressure, followed by stress and medication, and the most accessed feature was viewing graphs of data trends. Conclusions: This study shows that a commercially available app can be usable and acceptable in the self-management of hypertension but also found a considerable number of possibilities for improvement, which needs to be considered in future app development. The results show that there is potential for a commercially available app to be used in large-scale studies of hypertension self-management if suggestions for improvements are addressed. |
المؤتمرات العلمية |
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المؤتمر (1): | |
عنوان المؤتمر: |
SAPC South East Regional Conference |
تاريخ الإنعقاد: |
24/01/2020 |
مكان الإنعقاد: |
Madingley Hall, Cambridge, UK |
طبيعة المشاركة: |
Oral presentation |
عنوان المشاركة: |
What Influences the Implementation of Shared Decision Making: An Umbrella Review |
ملخص المشاركة: |
Problem: In recent decades, Shared Decision Making (SDM) in healthcare has been increasingly advocated as an idealized form of clinical practice. Commensurately, research into this topic has also grown and the number of studies on this topic has increased over time. There is a wide diversity of studies from around the world on this topic from a myriad of different clinical settings. This presents a challenge to health professionals and managers seeking to implement SDM into their services. Consequently, there is a need for a cogent summation of the evidence base that clearly articulates the key barriers and facilitators to implementing SDM. We set out to address this through an umbrella review of existing systematic reviews on SDM Approach: An umbrella review of systematic literature reviews reporting barriers and facilitators to shared decision making was conducted. Databases of MEDLINE via Ovid, PsycINFO via Ovid, CINAHL, Scopus, and Cochrane Library were searched from 1997 to December 2018. The search included other sources such as reference lists of included reviews, articles citing the included reviews, and Google Scholar. Studies were included if they performed a systematic review of barriers and facilitators to shared decision making. Findings: Results: 7 eligible reviews were identified and most of the included reviews performed well on the CASP checklist. Themes and subthemes were identified from the findings. The six themes that emerged were: patient factors, professional factors, environmental factors, decision factors, relationship factors, and factors related to information provision. Conclusions: The results of this review support the idea that there is a need for providing extra time to involve patients and clinicians in the process of SDM. The healthcare providers need to be supported and motivated to use SDM. On the other hand, healthcare providers should consider the importance of building a good relationship with their patients, which facilitates the exchange of information between them. Implications: Most of the studies included in the reviews were conducted in developed Western countries, so there remains a need for further research on SDM to be conducted in non-Western settings, and in particular in developing countries where cultures, social contexts, and health care systems are different from developed countries. The generalisability of findings worldwide as well as its translation into practice is uncertain. Most of the studies focused at the clinician-service user/carer level. This highlights a paucity of research at a systems-level and further research is needed to understand factors perceived by organizational managers and policymakers that may facilitate the implementation of SDM. |
الرابط: |
نوف عوض الله أحمد السلمي
دكتوراه
الطب والخدمات الصحية
The University of Sheffield