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Table 3 Empirical results on barriers and facilitators

From: Patients’ and healthcare professionals’ perceived facilitators and barriers for shared decision-making for frail and elderly patients in perioperative care: a scoping review

Category

Stakeholder

Facilitators (Nr. of articles)

Barriers (Nr. of articles)

Attitude and Behavior

Patient factors

Active behavior (9)

Depending on family or healthcare personnel (6)

 

Confidence in participating in decisional involvement (3)

Not having a choice (4)

 

Wanting to be informed or demanding more information (7)

Not wanting to participate in decision-making (4)

 

Wanting to be involved through decisional participation (9)

Being enabled to ask questions and make decisions (2)

Passive behavior (6)

  

Submissive behavior (3)

Being overstrained (2)

Discomfort due to too much involvement (1)

Healthcare personnel factors

 

No decisional involvement of patients (6)

  

No treatment or information involvement of patients (5)

Trust and Power

Patient factors

Exercising power and dominance (6)

Asymmetric power relationship (4)

 

Unknown healthcare provider (3)

Fear of incompliance (1)

  

Feeling controlled (1)

  

Feeling incapacitated (2)

  

Feeling powerless / Having no control (3)

  

Institution of power and/or trust (1)

  

Passive behavior (6)

  

Submission towards healthcare personnel (3)

  

Submissive communication semantics (2)

  

Submissive behavior (3)

  

Trust towards healthcare personnel (4)

  

Unknown healthcare provider (4)

Healthcare personnel factors

 

Asymmetric power relationship (4)

  

Exercising power and dominance (5)

  

No treatment or information involvement of patients (5)

Decision-making interaction factors

 

Asymmetric power relationship (4)

Trust towards healthcare personnel (4)

Unknown healthcare provider (4)

Knowledge and Communication

Patient factors

Adequate medical knowledge (1)

Depending on family or healthcare personnel (6)

 

Being offered a choice (1)

Ease of non-involvement (1)

 

Internet as source for medical information (2)

Knowledge/Competence asymmetry (5)

 

Medical knowledge is not required (2)

Lack of medical or treatment related knowledge (5)

 

Supporting family involvement (1)

Prior misinformation through family, friends, internet or other sources (1)

 

Wanting to be informed or demanding more information (7)

Submissive communication semantics (2)

 

Wanting to be involved through decisional participation (9)

 
 

Wanting to express themselves, issue opinions and preferences and to be heard (6)

Satisfying information sharing (3)

 

Healthcare personnel factors

Comprehensive communication (1)

Dominant communication semantics (2)

Linguistic issues (3)

No treatment or information involvement of patients (5)

Decision-making interaction factors

 

Diverging perceptions of health condition, treatment or surgical outcome (1)

Knowledge/Competence asymmetry (5)

Healthcare system /organizational factors

 

No treatment or information involvement of patients (5)

Treatment Organization and Risk

Patient factors

Alternative choices / Ambiguity (2)

Satisfying information sharing (3)

Treatment satisfaction (3)

Satisfying involvement (2)

Diminution of decisional conflict (1)

Facing different treatment strategies (1)

Timely treatment necessity (2)

Treatment related dismissal of decisional involvement (5)

Healthcare personnel factors

 

Facing different treatment strategies (1)

Time pressure (5)

Decision-making interaction factors

SDM mediator (1)

Treatment related dismissal of decisional involvement (5)

High workload (3)

Healthcare system /organizational factors

Adequate workload (1)

Formal SDM approach (1)

Acute setting (1)

Healthcare staff rotation (2)

High Workload (3)

Lack of integration in social practices (3)

Patient turnover (1)

Scheduling issue (1)

Health and Age

Patient factors

 

Being ill (2)

Being in pain (2)

Being old (4)

Being overstrained (3)

Being tired (1)

Forgetting discussions or given information (2)

Timely treatment necessity (2)

Discomfort due to too much involvement (1)

Healthcare system /organizational factors

Need for individualized care - Treatment complexity and multimorbid patients (3)