Shared decision-making (SDM) is a collaborative approach that involves patients, their families, and healthcare providers in making health-related decisions. While this approach is gaining traction in adult medicine, its implementation in pediatric practice remains limited. A recent systematic review titled "Barriers and facilitators of pediatric shared decision-making: a systematic review" sheds light on the factors influencing SDM in pediatric settings. Let's explore how practitioners can leverage these insights to improve their skills and foster better outcomes for young patients.
Understanding the Barriers
The review identifies several barriers that hinder effective SDM in pediatrics:
- Features of Options: Parents often perceive a lack of viable options or find alternatives unacceptable due to affordability or insufficient evidence.
- Poor Quality Information: Inadequate or poorly tailored information can prevent families from engaging meaningfully in the decision-making process.
- Time Constraints: Healthcare providers frequently cite insufficient time as a barrier to implementing SDM effectively.
- Power Imbalances: Children may feel disempowered or intimidated, hindering their participation in discussions.
The Role of Facilitators
The review also highlights facilitators that can enhance SDM in pediatric practice:
- High-Quality Information: Providing information that is well-tailored to the child's developmental stage and the family's literacy needs is crucial.
- Trust and Respect: Building trustful relationships between healthcare providers and families fosters open communication and collaboration.
- Adequate Resources: Access to tools like patient decision aids and training for healthcare providers can significantly improve SDM processes.
Practical Strategies for Practitioners
Pediatric healthcare providers can adopt several strategies to overcome barriers and leverage facilitators for effective SDM:
- Cultivate Open Communication: Encourage children and parents to voice their preferences and concerns. Use age-appropriate language to ensure understanding.
- Tackle Time Constraints: Integrate SDM into routine practice by streamlining workflow and allocating dedicated time for discussions with families.
- Provide Comprehensive Information: Develop resources that present all treatment options clearly, including potential risks and benefits, to empower families in decision-making.
- Nurture Trustful Relationships: Foster a supportive environment where families feel respected and valued as partners in care.
The Ottawa Model of Research Use
The Ottawa Model of Research Use (OMRU) provides a theoretical framework for implementing evidence-based practices like SDM. It emphasizes the importance of assessing barriers and facilitators at different levels—decision, innovation, adopters, relational, and environment—and designing interventions accordingly. By applying the OMRU framework, practitioners can tailor their approaches to specific contexts, enhancing the uptake of SDM practices in pediatric settings.
The Path Forward
The findings from this systematic review offer valuable insights into the complex interplay of factors influencing SDM in pediatric practice. By understanding these dynamics, healthcare providers can develop targeted interventions that minimize barriers and leverage facilitators. This not only empowers children and their families but also enhances the quality of care delivered. As practitioners continue to refine their skills in shared decision-making, they contribute to a more collaborative and patient-centered healthcare system.
If you're interested in delving deeper into this topic, consider exploring further research or attending relevant conferences and webinars. Staying informed about the latest developments in pediatric SDM will equip you with the knowledge needed to drive positive change in your practice.
Barriers and facilitators of pediatric shared decision-making: a systematic review
